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Pain control during diagnostic and/or therapeutic procedures in children
M Astuto1, C Favara-Scacco, E Crimi
1Department of Anesthesia and Care Unit, University of Catania, Catania, Italy. astmar@tiscalinet.it
Insights
Children with cancer experience significant fear of pain, impacting their emotional well-being. Early and comprehensive pain management is crucial to prevent long-term psychological trauma.
Area of Science:
- Pediatric Oncology
- Pain Management
- Child Psychology
Background:
- Children's fear of pain during illness, particularly cancer, is often underestimated.
- Pain is a common characteristic of cancer diagnostics and long-term treatments.
- Illness and pain can lead to psycho-emotional distress, including loss of control, anger, fear, and fear of death.
Purpose of the Study:
- To highlight the underestimated fear of pain in children with cancer.
- To emphasize the importance of pharmacologic and psychologic support for coping with pain.
- To prevent traumatic effects on a child's future personality and behavior after treatment.
Main Methods:
- Implementing support from the first intrusive procedure to avoid anticipatory anxiety.
- Utilizing non-pharmacologic techniques such as respiration, relaxation, visualization, distraction, and muscular relaxation.
- Employing medical methods like local anesthesia and conscious sedation tailored to the child's age and consciousness level.
Main Results:
- Psycho-emotional support helps children cope with pain and illness-related trauma.
- Techniques like the 'switch technique' and 'magic glove' aid in redirecting attention from pain.
- A serene and comfortable environment is essential for sensitive pediatric patients.
Conclusions:
- Early and comprehensive pain management is vital for children with cancer.
- Integrated pharmacologic and psychologic support is key to mitigating the psycho-emotional impact of cancer pain.
- Relieving pain and suffering is a fundamental ethical consideration in pediatric oncology.
Abstract:
Children's fear of pain in illness has been greatly underestimated. In cancer disease, pain characterizes most of the diagnostic and long-term therapeutic procedures. Children's psycho-emotional processing during illness has been recently recognized as characterized by loss of control, anger, and fear, to which pain adds fear of death jeopardizing the sense of survival. Illness and pain provoke a traumatic condition affecting psycho-emotional maturation. The aim of the pharmacologic and psychologic support is to help children better cope with pain and prevent the healed child having traumatic effects in his/her future personality structure and behavior. To assure the best pain control, support has to be offered right from the first intrusive procedure in order to avoid anticipatory anxiety. Respiration, relaxation, visualization, desensibilization through the "switch technique" and the "magic glove", distraction and involvement, muscular relaxation all have the common aim of focusing the child's mind and attention away from body perception of pain connected to the procedure. Different medical methods are utilized depending on the child's age and the level of consciousness required for the procedure. Local anaesthesia and conscious sedation are used. Children are particularly sensitive in this critical condition and need as serene and comfortable an environment as possible. Relief of pain and suffering in cancer treatments that cause further discomfort to the patient is a fundamental ethics in the treatment of clinical neoplasias.