ABSTRACT : Communication skills are an important part of anaesthesia practice. Although intravenous cannulation is a minor procedure, pain may be of moderate intensity and cause significant anxiety to the patient. We planned to study how patient\'s perception of pain may be modified by the communication immediately preceding cannulation. Our aim of the study was to study the effect of 3 different types of communication provided by the anaesthesiologists on the perception of pain by patients following IV cannulation procedure (primary outcome). Presence of behavioural/ visual discomfort during IV cannulation procedure (secondary outcome)

METHODS : A total of 300 patients were included and were randomly allocated into 3 groups by computer generated randomisation table. All patients aged above 18 years , scheduled for elective surgery and who could understand english or kannada. There were 2 obsrevers, obsrver 1 myself who is blinded to patient, assessed the pain post ivcannulation and behavioural signs of pain. Observer 2, consultant anaesthesiologist performed the cannulation and recorded number of attempts. The 3 different groups were Sting group (positive statement), No Pain group (negative statement) and Numb group (neutral statement).A maximum of 2 attempts were permitted and 18 guage cannula is secured after giving 0.25 ml of 2% lignocaine subcutaneously over dorsum of upper limbs. Observer 2 opened sealed envelope and allocated statement was communicated to the patient. Observer 1 who joined after the allocated statement was communicated and assessed the degree of pain perception using VAS score [Nopain-0, Mild pain- >0to<4, Moderate pain-4to<7, Severe pain-7to10] and by Modified Behavioural Pain Rating Scale score[No pain-0, Mild to Moderate pain-1, Severe pain-2]. Observer 1 also obtained answers for some of the Questionnaire.

RESULTS : Out of 300 patients 285 patients had first attempt and 12 patients had second attempt, more than 2 attempts were found in 3 patients and were excluded. In Sting group 119 patients, No pain group 87 patients and Numb group 91 patients were present. Total of 143 patients in young age group, 108 patients in middle age group and 46 patients in old age group. Total of 186 patients were male and 111 patients were female. The demography data obtained was not statistically significant using Chi-square test. The VAS score was compared between the 3 groups and was found to be statistically not significant using Chi-square test.Even MBPRS score obtained for local anaesthesia and ivcannulation was found to be statistically not significant using Chi-square test.

CONCLUSIONS : The intensity of pain perceived during the procedure of intravenous cannulation is similar for patients irrespective of the type of communication provided by the operator. Behavioural display of pain for both local anaesthetic injection and intravenous cannulation is not influenced by the type of communication received by a patient prior to the procedure.