Cannula Type and Pain Response in Pediatric Rectal Suspension: A Prospective Study

Functional constipation is a prevalent condition in children, often requiring rectal suspension as part of its management. While various cannula types are available for this procedure, their impact on pain perception remains understudied.

This prospective observational study was conducted in the pediatric emergency unit of a central city hospital in Turkey. Children aged 1-3 years, diagnosed only with functional constipation, treated with sorbitol + glycerin (SG) or monobasic sodium phosphate dehydrate + dibasic sodium phosphate dodecahydrate (MD), who had not completed toilet training and had no chronic illness, were included in the study (n = 156). In the study, data were collected using the "patient information form" and "face, legs, activity, cry, and consolability (FLACC) behavioral scale."

Of the children, 61.9% had experienced constipation 2-3 times before. During the procedure, the mean FLACC score was 8.09 ± 1.49 in the SG applicator group and 4.75 ± 1.75 in the SG catheter group (P ≤ 0.001); it was 8.72 ± 1.57 in the MD applicator group and 5.09 ± 1.54 in the MD catheter group (P ≤ 0.001). In both types of rectal suspensions, during the procedure the mean HR in the applicator group was higher (P ≤ 0.001), and the mean SpO₂ was lower compared to the catheter group (P ≤ 0.001).

Rectal suspension administration causes pain in children with functional constipation. Children experienced moderate pain with rectal suspension administered via catheter and above-average pain with rectal suspension administered via applicator. Using a catheter instead of an applicator for rectal suspension is a more clinically appropriate option.