Comparison of Pain Perception between the Antecubital Fossa (ACF) and the Dorsum of the Hand (DOH) During Peripheral Venous Cannulation in Adult Surgical Patients: A Descriptive Observational Study

Background: Peripheral venous cannulation is one of the most frequently performed invasive procedures in hospital settings and is often associated with pain, discomfort, and anxiety.Despite its routine nature, cannulation-related pain is frequently underestimated by healthcare professionals, and site selection is commonly guided by vein visibility and accessibility rather than patient comfort.This study aimed to compare pain perception between cannulation of the dorsum of the hand and the antecubital fossa among adult patients undergoing elective surgery and to examine the influence of age, gender, and cannula gauge on pain perception.Methods: A descriptive observational study was conducted among 180 adult patients aged 18-65 years admitted for elective surgical procedures in a tertiary care teaching hospital in Sri Lanka.Pain experienced during cannulation was assessed immediately after the procedure using a validated 100-mm Visual Analog Scale (VAS).Independent sample t-tests were used to compare mean pain scores between cannulation sites.A three-way analysis of variance (ANOVA) examined the main and interaction effects of cannulation site, age group, and gender.Results: Cannulation at the dorsum of the hand was associated with significantly higher pain perception compared to the antecubital fossa (mean ± SD: 47.29 ± 16.19 vs. 26.74± 15.42; P < 0.001).Cannulation site demonstrated a significant main effect on pain perception, accounting for the largest proportion of variance (partial η 2 = 0.223).No statistically significant main effects were observed for age or gender, and no interaction effects between site, age, and gender were identified. Conclusions:Peripheral venous cannulation at the antecubital fossa is associated with significantly lower pain perception compared to cannulation at the dorsum of the hand.Incorporating pain-minimizing site selection into routine cannulation practice may enhance patient comfort.