Procedural anesthesia and sedation for children undergoing diagnostic and medical procedures – a review of post‐procedural pain, nausea and vomiting by questionnaire‐based survey

2021 ◽  
Author(s):  
Chloe Batchelor ◽  
Thomas Drake‐Brockman ◽  
Andrew Lowe ◽  
Aine Sommerfield ◽  
Britta S von Ungern‐Sternberg ◽  
...  
2019 ◽  
Vol 11 (1) ◽  
pp. 55
Author(s):  
Joanne V. Loewy

The following is a position paper substantiating the recommendation for an integrative approach to evaluate, treat and manage the predictable and/or unpredictable experience of pain in medical procedures so frequently required for infants, children and adult patients. Although decades of articles in journals and texts support distraction as a recommendation for protecting and diffusing a patient’s experience of procedural pain, the rationale for thorough evaluation followed by suggestions for the provision of integration as a treatment option is described and considered as a best practice intervention. 


2008 ◽  
Vol 5 (4) ◽  
pp. 399-407 ◽  
Author(s):  
Jennie C. I. Tsao ◽  
Subhadra Evans ◽  
Marcia Meldrum ◽  
Tamara Altman ◽  
Lonnie K. Zeltzer

This article is the second in a two-part series reviewing the empirical evidence for complementary and alternative medicine (CAM) approaches for the management of pain related to medical procedures in infants up to 6 weeks of age. Part I of this series investigated the effects of sucrose with or without non-nutritive sucking (NNS). The present article examines other CAM interventions for procedural pain including music-based interventions, olfactory stimulation, kangaroo care and swaddling. Computerized databases were searched for relevant studies including prior reviews and primary trials. Preliminary support was revealed for the analgesic effects of the CAM modalities reviewed. However, the overall quality of the evidence for these approaches remains relatively weak. Additional well-designed trials incorporating rigorous methodology are required. Such investigations will assist in the development of evidence-based guidelines on the use of CAM interventions either alone or in concert with conventional approaches to provide safe, reliable analgesia for infant procedural pain.


2019 ◽  
Author(s):  
Ioana Cristea ◽  
Raluca Georgescu ◽  
Liviu Andrei Fodor

In a meta-analysis of twenty-seven randomized trials, VR-based distraction interventions for procedural pain demonstrated reductions in pain intensity, assessed either real-time or retrospectively, compared to treatment as usual. Though effects appeared generally large, they were associated by high heterogeneity, with all predictive intervals including zero.


2018 ◽  
Vol 8 (2) ◽  
pp. 33-39
Author(s):  
A. Bomersbach ◽  
L. Sochocka

<b>Introduction:</b> Newborns born prematurely and treated in intensive care units are at greater risk of experiencing pain than patients treated in other units. <b>Purpose:</b> To evaluate the severity of pain perceived by children during the performance of medical procedures related to the treatment and care process. <b>Materials and methods:</b> The study was conducted at one of the Intensive Care Units in Opole. The study group consisted of 100 newborns, 60% of the subjects were prematurely born newborns, and 40% - were full-term. The degree of procedural pain associated with blood collection, peripheral puncture insertion, upper respiratory tract suction, gastric tube insertion and ophthalmic examination was assessed by an observation method using the standard Neonatal Infant Pain Scale Form (NIPS). <b>Results:</b> Out of the analysed medical procedures, 100% of children experienced acute, severe pain over the course of suction and ophthalmological examination. The highest perception of pain was experienced by 88.3% of premature newborns and 71.8% of full-term newborns. Over the course of medical procedures, 84% of male and 79.6% female newborns experienced acute pain. It was shown that the degree of pain perception was determined by the type of performed medical procedure (p=0.001) and the gestational age of the newborn (p=0.037). On the other hand, there was no correlation between the sex of the newborn child and the degree of pain perception (p=0.758). <b>Conclusions:</b> Based on the foregoing study result, bearing in mind the need to minimise the effects of pain stimulation, it seems important to use standardised tools to assess the severity of pain in newborns treated in Intensive Care Units on a larger scale.


2021 ◽  
Vol 2 ◽  
Author(s):  
Rikke Nordgård ◽  
Torstein Låg

Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided.


2008 ◽  
Vol 5 (4) ◽  
pp. 371-381 ◽  
Author(s):  
Jennie C. I. Tsao ◽  
Subhadra Evans ◽  
Marcia Meldrum ◽  
Tamara Altman ◽  
Lonnie K. Zeltzer

There is increasing concern regarding the number of painful medical procedures that infants must undergo and the potential risks of alleviating infant pain with conventional pharmacologic agents. This article is Part I of a two-part series that aims to provide an overview of the literature on complementary and alternative (CAM) approaches for pain and distress related to medical procedures among infants up to six weeks of age. The focus of this article is a review of the empirical literature on sucrose with or without non-nutritive sucking (NNS) for procedural pain in infancy. Computerized databases were searched for relevant studies including prior reviews and primary trials. The most robust evidence was found for the analgesic effects of sucrose with or without NNS on minor procedural pain in healthy full-term infants. Despite some methodological weaknesses, the literature to date supports the use of sucrose, NNS and other sweetened solutions for the management of procedural pain in infancy.


2021 ◽  
Author(s):  
Anne Le ◽  
Lisa Hartling ◽  
Shannon D. Scott

Procedures carried out in acute care settings, such as emergency departments (EDs), are among the most common sources of acute pain experienced by children. Such procedures may include intravenous insertions (IVs), venipuncture, and wound irrigation and repair. Inadequately managed procedural pain can cause negative short-term and long-term implications for children, ranging from anxiety to aversion to healthcare. Parents have repeatedly expressed that they do not have the necessary tools to comfort or distract their child during uncomfortable medical procedures. As such, the purpose of this study was to work with parents to develop and evaluate two digital tools for pediatric procedural pain. A whiteboard animation video and interactive infographic were developed following a systematic review and interview with parents. Prototypes were tested in five ED waiting rooms in two Canadian provinces. Sites included those in urban, rural, and remote settings. Overall, parents rated the tools highly, suggesting that engaging with parents to develop arts-based digital tools is a highly effective method in ensuring that parents can understand and utilize complex health information.


Ból ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 17-24
Author(s):  
Paulina Pisaniak ◽  
Greta Śmietana ◽  
Dorota Ozga

Immediately after birth, most newborns undergo a number of medical procedures to assess how the body functions. Some of these procedures are invasive and involve breaking the continuity of the baby's tissues, leading to pain and discomfort. Confirmation of pain sensation by newborns is relatively one of the newer scientific discoveries - this fact was not acceptable until the end of the 1980s. Therefore, analgesia was used very rarely during all medical procedures. Nowadays, medical personnel are aware that the youngest patients also feel pain and should be knowledgeable about its prevention and treatment. The aim of the study is to analyze the available studies on glucose supply as a way to reduce procedural pain in newborns. The non-systematic review of the literature was carried out according to the following keywords: pain, glucose, newborn, prevention, recommendations. Analyzes carried out in neonatal departments and a literature review have shown that pain prevention and treatment still pose many problems, as there are no clear guidelines as to how and methods to administer the therapy. Oral glucose is the most common pain reliever used in neonates during medical interventions. Its mechanism of action remains unclear, but it is believed to have a calming effect and reduce behavioral indicators of pain. The American Academy of Pediatrics recommends the administration of three doses of sucrose appropriate to the gestational age of the newborn, but there is concern about the long-term use of this preventive measure, especially in premature babies, who are at greater risk of hyperglycemia and disturbances in the development of the nervous system.


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