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Do children undergoing cancer procedures under pharmacological sedation still report pain and anxiety? A preliminary

Alexandra Dufresne1, Marc-André Dugas, Yvan Samson

  • 1Department of Pediatrics, Universite Laval, Quebec, Canada.

Pain Medicine (Malden, Mass.)
|September 8, 2009
PubMed

Insights

Intravenous sedation effectively reduces children's procedural pain and fear. However, children still anticipate anxiety, and parents experience significant anxiety. Hypnosis may offer additional benefits for managing procedural anxiety in children and parents.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Child Psychology

Background:

  • Needle-based procedures in children often induce significant pain and fear.
  • Intravenous sedation-analgesia is commonly used to manage procedural pain and anxiety.
  • The effectiveness of non-pharmacological interventions alongside sedation requires further investigation.

Purpose of the Study:

  • To quantify children's pain and fear levels during needle puncture procedures.
  • To evaluate the efficacy of intravenous sedation-analgesia in reducing procedural distress.
  • To assess the potential role of non-pharmacological interventions, such as hypnosis, in managing pediatric procedural anxiety.

Main Methods:

  • A cohort of 14 children undergoing needle puncture procedures were assessed.
  • Pain and fear were measured using the Visual Analog Scale (VAS) by children, parents, and physicians before and during procedures.
  • Intravenous sedation-analgesia (midazolam/ketamine) was administered during the procedures.

Main Results:

  • Sedation significantly reduced children's pain and fear levels during procedures.
  • Children's self-reported pain during sedation did not correlate with parent or physician ratings.
  • Children who anticipated higher pain and fear experienced greater distress during the procedures.
  • Parents reported significant pre-procedural anxiety, which did not correlate with their children's fear.

Conclusions:

  • Intravenous sedation-analgesia is effective in mitigating children's procedural pain and fear.
  • Children's anticipatory anxiety remains a concern despite sedation.
  • Parents experience considerable anxiety related to their child's procedures.
  • Hypnosis presents a promising adjunctive therapy for managing anxiety in both children and parents during medical procedures.
Abstract

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