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Analgesia for venepuncture in a paediatric surgery centre
R P Brislin1, S A Stayer, R E Schwartz
1Department of Anesthesia and Critical Care, St Christopher's Hospital for Children, Pennsylvania, United States.
Journal of Paediatrics and Child Health
|December 1, 1995
Summary
Oral midazolam with nitrous oxide effectively manages pain and anxiety during venepuncture in children aged 8 and older. Adding EMLA cream or lidocaine reduced patient movement during the procedure.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Ambulatory Surgery
Background:
- Venepuncture in children can be painful and anxiety-provoking.
- Effective pain management is crucial in pediatric ambulatory surgery centers.
Purpose of the Study:
- To determine an effective and efficient method for painless venepuncture in pediatric patients aged 8 years and older.
- To evaluate the efficacy of different analgesic adjuncts combined with nitrous oxide.
Main Methods:
- Sixty patients (8-21 years) were randomized into three groups: nitrous oxide with EMLA cream, nitrous oxide with intradermal lidocaine, or nitrous oxide alone.
- All patients received oral midazolam for anxiolysis.
- Sedation, anxiolysis, and pain response were assessed using observer and patient scores.
Main Results:
- No significant differences in sedation or anxiolysis were observed between groups.
- The control group (nitrous oxide alone) showed a higher incidence of withdrawal or vocalization during venepuncture.
- Patient-reported pain scores for venepuncture did not differ significantly across the groups.
Conclusions:
- Oral midazolam combined with 50% nitrous oxide provides adequate analgesia and anxiolysis for venepuncture in older children.
- EMLA cream or intradermal lidocaine can decrease patient movement during venepuncture.