Coughing can reduce pain of injection, study shows

To the editor,

Whilst the above article shows promise in reducing pain associated
with venipuncture, suggestions that this technique would cause an increase
in blood pressure may not always be true. Venipuncture is commonly
associated with vasovagal reactions, which may occur in as many as 8% of
subjects unused to blood donation [1]. Like venipuncture, coughing itself
is a recognised cause of vasovagal reactions, presumably both through a
vasalva effect and stimulation of lung receptors [2]. It would therefore
be prudent to emphasise the importance of placing the patient in the
supine position prior to applying, simultaneously, these two potential
inducers of vasovagal syncope.

Dr Tim Young BSc. MBBS MRCP

Clinical Research Fellow

References:

1. Newmann B.H. Vasovagal reaction rates and body weight findings in
high and low risk populations. Transfusion 2003; 43(8): 1084-8

2. Daly M. de. B., Hazzledine J.L., Ungar A. The reflex effects of
alterations in lung volume on systemic vascular resistance in the dog.
Journal of Physiology 1967; 188: 331-51

Competing interests:
None declared