Making medical procedures less painful for kids – the evidence

Source: Wikimedia Commons

Source: Wikimedia Commons

April 20, 2015 – This week’s blog post is also available from TREKK (TRanslating Emergency Knowledge for Kids).

Today we are going to discuss 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 immunizations 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.

060810-F-1830P-176

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!

Translating Emergency Knowledge for Kids (TREKK):

Other Resources:

  • A great video from the Centre for Pediatric Pain Research on reducing procedural pain – the producers of this video have no connection to our synthesis, but we think it’s a great video that deserves a wide audience, so please take a look!

References:

  1. Curtis, S., Wingert, A., & Ali, S. (2012). The Cochrane Library and procedural pain in children: an overview of reviews. Evidence‐Based Child Health: A Cochrane Review Journal, 7(5), 1363-1399.

2 thoughts on “Making medical procedures less painful for kids – the evidence

  1. This is such an important topic to share amongst clinicians, particularly us practising in the public sector. We tend not to give much attention to the trauma procedural pain causes kids, just because most of the time they do not complain. Pain minimising techniques are not expensive. Applying elma to a child before drawing blood or inserting an IV line cost the state close to nothing but saves the child from a lot of trauma that could affect his/her behaviour into adulthood and the way they view seeking help for health reasons.

  2. It is not easy to divert the attention of children from painful procedures, however one must attempt one of the methods to reduce the pain and I think video movies is the better option to reduce the feeling of pain.

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