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The use of topical anaesthesia at children's minor lacerations: an experimental study
Camilla Adriansson1, Björn-Ove Suserud, Ingegerd Bergbom
1Borås University College, School of Health Sciences, Kunskapscentrum PreHospen, Borås 501 90, Sweden.
Insights
Topical anesthesia with Xylocain offered some pain relief for children during wound suturing, but did not significantly reduce pain compared to a saline solution. Further research is needed to confirm its effectiveness in managing pediatric procedural pain.
Area of Science:
- Pediatric Pain Management
- Anesthesiology
- Emergency Medicine
Background:
- Children frequently experience unnecessary pain during medical procedures like wound suturing.
- Current practices in administering local anesthetics can cause significant pain, contradicting assurances of painlessness.
- Effective pain management for children undergoing procedures is crucial in healthcare settings.
Purpose of the Study:
- To evaluate the efficacy of topical Xylocain as a preliminary anesthetic before infiltration anesthesia in children.
- To compare pain experienced by children receiving topical Xylocain versus a saline solution before infiltration anesthesia.
- To assess the impact of topical anesthesia on pain perception during infiltration anesthesia for wound suturing.
Main Methods:
- A prospective, experimental study design was employed.
- Two groups of children (n=10 each) were included: an experimental group receiving topical Xylocain and a control group receiving saline solution.
- Pain was assessed using Visual Analog Scale (VAS) estimates and through interviews.
Main Results:
- Topical Xylocain provided some pain alleviation, but no statistically significant difference in pain was observed between the Xylocain and saline groups.
- Children in both groups reported pain during infiltration anesthesia.
- A notable finding was the prevalence of fear and anxiety among the children studied.
Conclusions:
- Satisfactory pain relief for children undergoing infiltration anesthesia and wound suturing remains a challenge.
- Further investigation into pediatric pain, from both nursing and medical perspectives, is urgently required.
- While Xylocain showed a potential positive effect during infiltration, larger studies are necessary to establish its definitive benefit.
Background:
In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia.
Aim:
The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews.
Result:
The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety.
Conclusion:
Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children's pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children's reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
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