A randomized controlled trial of sucrose and/or pacifier as analgesia for infants receiving venipuncture in a pediatric emergency department

Curtis, Sarah; Jou, Hsing; Ali, Samina; Vandermeer, Ben; Klassen, Terry P.

doi:10.1186/1471-2431-7-27

Cited by 89 publications

(73 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite the availability of effective topical analgesic agents for urinary catheterization, which is known to be pain and anxiety provoking, 27,28 60% of physicians in our study reported providing no analgesia for pediatric urinary catheterizations. Similarly, although IV insertion is known to cause moderate pain in infants and many options exist to limit this pain, 15,20,21,25,29 only half of physicians reported that they ''often or always'' used analgesia for venipuncture. LP is another procedure for which multiple effective analgesic interventions exist and are recommended in the literature.…”

Section: Discussionmentioning

confidence: 99%

Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians

Ali

Chambers

Johnson

et al. 2014

CJEM

Self Cite

View full text Add to dashboard Cite

Objectives: To describe pediatric emergency medicine (PEM) physicians' reported pain management practices across Canada and explore factors that facilitate or hinder pain management. Methods: This study was a prospective survey of Canadian pediatric emergency physicians. The Pediatric Emergency Research Canada physician database was used to identify participants, and a modified Dillman's Total Design Survey Method was used for recruitment.Results: The survey response rate was 68% (139 of 206). Most physicians were 31 to 50 years old (82%) with PEM training (56%) and had been in practice for less than 10 years (55%). Almost all pain screening in emergency departments (EDs) occurred at triage (97%). Twenty-four percent of physicians noted institutionally mandated pain score documentation. Ibuprofen and acetaminophen were commonly prescribed in the ED for mild to moderate pain (88% and 83%, respectively). Over half of urinary catheterizations (60%) and intravenous (53%) starts were performed without any analgesia. The most common nonpharmacologic interventions used for infants and children were pacifiers and distraction, respectively. Training background and gender of physicians affected the likelihood of using nonpharmacologic interventions. Physicians noted time restraints to be the greatest barrier to optimal pain management (55%) and desired improved access to pain medications (32%), better policies and procedures (30%), and further education (25%). Conclusions: When analgesia was reported as provided, ibuprofen and acetaminophen were most commonly used. Both procedural and presenting pain remained suboptimally managed. There is a substantial evidence practice gap in children's ED pain management, highlighting the need for further knowledge translation strategies and policies to support optimal treatment. RÉ SUMÉObjectifs: L'é tude visait à dé crire les pratiques, dé claré es par les inté ressé s, en matiè re de prise en charge de la douleur en mé decine d'urgence pé diatrique (MUP), au Canada, et à examiner les facteurs qui facilitent ou, au contraire, entravent le traitement de la douleur. Mé thodes: Il s'agit d'une enquê te prospective, mené e parmi des urgentologues pé diatres au Canada. La base de donné es du Groupe de Recherche en Urgence Pé diatrique du Canada pour les mé decins a servi à repé rer les sujets é ventuels, et une version modifié e de la Dillman's Total Design Survey Method a é té utilisé e aux fins de participation. Ré sultats: Le taux de ré ponse à l'enquê te a atteint 68% (139 participants sur 206). La plupart des mé decins é taient â gé s de 31 à 50 ans (82%) avaient reç u une formation en MUP (56%) et pratiquaient depuis moins de 10 ans (55%). Le dé pistage de la douleur au service des urgences (SU) se faisait presque toujours au moment du triage (97%). Vingtquatre pour cent des mé decins ont fait é tat d'une documentation obligatoire sur l'é valuation de la douleur dans leur é tablissement. L'ibuprofè ne et l'acé taminophè ne (88% et 83%, respectivement) é taient souvent prescr...

show abstract

Section: Discussionmentioning

confidence: 99%

Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians

Ali

Chambers

Johnson

et al. 2014

CJEM

Self Cite

View full text Add to dashboard Cite

show abstract

“…ten is the maximum score indicating severe pain and a score < 2 generally indicates absence of pain 22,23 . A FlACC score higher than 4 is considered as indicator of moderate pain 24 .…”

Section: Data Collectionmentioning

confidence: 99%

Videogame playing as distraction technique in course of venipuncture

et al. 2012

View full text Add to dashboard Cite

Riassuntole procedure di venipuntura ed incannulamento venoso sono la causa più comune di dolore e distress nel bambino. ridurre il dolore e l'ansia ad esse correlati potrebbe essere importante per prevenire le reazioni di distress in corso di ulteriori procedure, soprattutto per quei bambini con patologia cronica che necessitano di controlli o ricoveri multipli. l'obiettivo di questo trial randomizzato controllato, condotto in aperto, è stato quello di valutare nel bambino l'efficacia dell'aggiunta di una strategia di distrazione attiva (videogame) sul dolore procedurale da venipuntura.Metodi: Sono stati reclutati 109 bambini di età compresa tra i 4 e i 10 anni; di questi 97 sono stati randomizzati e suddivisi in due gruppi: un gruppo di controllo (CC) che ha ricevuto solo le cure convenzionali, ovvero la premedicazione con eMlA, e un gruppo sperimentale (Ad) in cui alle cure convenzionali è stata aggiunta la distrazione attiva con videogame. gli outcomes valutati sono stati il dolore riferito dal bambino, per mezzo della scala di autovalutazione FPS-r; la reazione comportamentale al dolore valutata da un osservatore secondo la scala FlACC; il numero di tentativi necessari per il successo delle procedure di venipuntura o incannulamento venoso. Risultati: in entrambi i gruppi la mediana dei punteggi FPS-r è stata 0, con un dolore significativo (FPS-r>4) riportato dal 9% dei soggetti. la mediana per quel che riguarda la scala FlACC è stata pari a 1 in entrambi i gruppi, mentre la percentuale di bambini con dolore grave (FlACC>4) è stata del 18% nel gruppo di controllo e del 9% in quello sperimentale; tale differenza non è statisticamente significativa (p=0.2). la mediana dei tentativi necessari è stata pari a 1 in entrambi i gruppi, con un range interquartile compreso tra 1 e 2. la distrazione attiva è stata applicata con facilità ed accettata molto bene sia dai bambini sia dagli operatori.Conclusioni: la distrazione attiva non migliora l'analgesia già fornita con eMlA per quel che riguarda le procedure di venipuntura ed incannulamento venoso, ciò nonostante è risultata essere facilmente applicabile e apprezzata dai bambini. Potrebbe essere utile indagare questa tecnica di distrazione in corso di altre procedure dolorose. AbstractBackground: needle-related procedures (venipuncture, intravenous cannulation) are the most common source of pain and distress for children. reducing needle related pain and anxiety could be important in order to prevent further distress, especially for children needing multiple hospital admissions. the aim of the present open randomized controlled trial was to investigate the efficacy of adding an active distraction strategy (videogame) to eMlA premedication in needle-related pain in children. Methods: one-hundred and nine children (4 -10 years of age) were prospectively recruited to enter in the study. ninety-seven were randomized in two groups: CC group (conventional care: eMlA only) as control group and Ad group (active distraction: eMlA plus videogame) as intervention group. outcome ...

show abstract

“…[51][52][53][54] In addition, a 50% glucose solution was no more effective than water during circumcision, 55 and a single dose of sucrose failed to significantly reduce crying in older infants undergoing urethral catheterization 56 and venepuncture. 57 The reduced effectiveness of sweet solutions in these more invasive procedures of relatively long duration may be due to the shortlasting effects of a single dose given 2 minutes before the procedures. Effects may not be sustained over prolonged procedures, especially in infants beyond the newborn period.…”

Section: Human Model Studiesmentioning

confidence: 99%

Sucrose for Procedural Pain Management in Infants

2012

View full text Add to dashboard Cite

The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. More than 150 published studies relating to sweet-taste-induced calming and analgesia in human infants have been identified, of which 100 (65%) include sucrose. With only a few exceptions, sucrose, glucose, or other sweet solutions reduced pain responses during commonly performed painful procedures in diverse populations of infants up to 12 months of age. Sucrose has been widely recommended for routine use during painful procedures in newborn and young infants, yet these recommendations have not been translated into consistent use in clinical practice. One reason may be related to important knowledge and research gaps concerning analgesic effects of sucrose. Notably, the mechanism of sweet-taste-induced analgesia is still not precisely understood, which has implications for using research evidence in practice. The aim of this article is to review what is known about the mechanisms of sucrose-induced analgesia; highlight existing evidence, knowledge gaps, and current controversies; and provide directions for future research and practice. Pediatrics 2012;130:918-925

show abstract

A randomized controlled trial of sucrose and/or pacifier as analgesia for infants receiving venipuncture in a pediatric emergency department

Cited by 89 publications

References 25 publications

Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians

Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians

Videogame playing as distraction technique in course of venipuncture

Sucrose for Procedural Pain Management in Infants

Contact Info

Product

Resources

About