Making medical procedures less painful for kids – the evidence

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Source: Wikimedia Commons

The purpose of our new Cochrane Child blog is to spread the word about important health research evidence that’s relevant to children and youth and those who look after them.  Why are we writing this blog?  Simply because we believe strongly that decisions about treatments given to kids should be based on the very best research.  In a world where new studies are published every day, we think there’s a place for places like this blog, which aim to help anyone looking for the best evidence to support their health care decisions.

We’re starting with a topic that will be familiar to any parent, or to anyone who’s ever been a kid: the pain from medical procedures.  These can range from immunisations and blood tests through to less common things like lumbar punctures, inserting a catheter or starting an intravenous line.  All of these procedures have an important goal: supporting diagnosis and treatment.  But they can be really stressful for both children and their caregivers.

Doctors used to think that very young children did not experience pain, and, even if they did, did not remember it.  This has been repeatedly disproven over the past twenty years or so, and we now know that inadequate pain treatment can have a lot of negative effects in both the short and long term.

The experience of pain for a child is complex and is usually accompanied by anxiety, fear and behavioural changes. In the case of pain from medical procedures, health care professionals have a range of options for preventing or reducing the negative experience.

The Child Health Field’s journal, Evidence-Based Child Health, has published an overview of Cochrane evidence on reducing and preventing procedural pain for kids.  The kids in the studies included in this synthesis ranged in age from infancy (but not newborns) up to 19 years. The overview found three main conclusions:

1)  Behavioural therapies, such as showing videos to kids to distract them during a procedure, are effective and inexpensive, and should be used.

2)  Sweet-tasting substances have proven pain-reducing effect for procedures in early infancy, but have not been shown to have similar effect in older children.

3)  Amethocaine, a topical anaesthetic, works and should be used.

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Source: Wikimedia Commons

Dr. Samina Ali, one of the authors of the synthesis, commented that, “Despite our understanding of the importance of pain relief in children, there remains a significant knowledge-practice gap in clinical practice.”  It is our hope that publishing this overview of evidence will help overcome this gap so that receiving care is less painful for kids!

We hope you’ve found this post interesting – we’d love it if you left a comment to let us know what you think of it.  Any and all feedback is welcome, and will be very helpful to us as we write posts over the coming weeks.  Please check back every Monday to see our topic of the week!

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