Buzzing Away Pain: Efficacy of Buzzy® in Reducing Pain During Canakinumab Treatment for Familial Mediterranean Fever

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Abstract
Background: In colchicine-resistant patients with familial Mediterranean fever (FMF), alternative therapies, which are administered parenterally, become necessary. Effective pain management is essential for FMF treatment. Buzzy® (Pain Care Labs, Atlanta, GA) is specifically designed to alleviate pain during needle procedures. This innovative tool integrates a cold pack with a vibration motor, thereby enabling the simultaneous application of cold therapy, tactile stimulation, and distraction techniques. By harnessing the combined effects of cold and vibration on the skin, Buzzy® significantly reduces pain perception. This study aimed to evaluate the effectiveness of Buzzy® in mitigating pain during subcutaneous administration of canakinumab in patients with FMF who are resistant to colchicine. This study included patients with colchicine resistance who were receiving canakinumab. Pain scores were evaluated before and after applying Buzzy® using the Visual Analog Scale (VAS), Wong-Baker FACES Pain Rating Scale (FPS-R), and Children’s Fear Scale (CFS). Results: A total of 15 patients were included in the study. Nine patients (60%) were female, and six (40%) were male. The median age of the patients was nine years (five to 18 years). The median VAS, FPS-R, and CFS scores before Buzzy® were four (0 to eight), four (0 to eight), and one (0 to four), respectively. After Buzzy® application, the median VAS, FPS-R, and CFS scores were two (0 to six), two (0 to six), and 0 (0 to three), respectively. The VAS and FPS-R scores showed a significant reduction (p=0.04 and p=0.008, respectively), indicating a notable decrease in pain. Although the CFS scores also decreased following the use of Buzzy®, this reduction was not statistically significant (p=0.526). Conclusion: According to the gate control theory of pain, methods like Buzzy® temporarily block pain signals from reaching the central nervous system by "closing the gates." In patients requiring continuous injections, such applications may reduce the pain and anxiety they experience.

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