Perception of pain during electromyography in children: A prospective study

Abstract

When discussing the test with patients, the physician should reassure the patient and parents regarding the degree of pain that may be encountered, which is not materially different from venipuncture. Muscle Nerve 54: 422-426, 2016.

Nerve conduction studies and EMG in carpal tunnel syndrome: Do they add value?

“…However, this is very rare if the recording from the second lumbrical muscle is attempted ( Boonyapisit et al, 2001 ). NCS are less uncomfortable than blood sampling for most people ( Alshaikh et al, 2016 ). No one would try to diagnose diabetes without knowing the blood sugar level because blood sampling is painful.…”

“…EDX are generally well tolerated by most individuals, especially the nerve conduction studies, which are non-invasive. Electromyography is less invasive than phlebotomy ( Alshaikh et al, 2016 ), as the needle gauge is smaller. Needle electromyography is also the only means by which motor axon loss can be definitively established.…”

Balancing placebo and nocebo effects during electromyography in children

“…The authors concluded that, when discussing the test with patients, it is reasonable to be reassuring with them regarding the level of pain they may experience, and it could be said with confidence that the procedure is not materially different from venipuncture. 1 However, I do not understand why, in their prospective study, they did not use any topical analgesics or local anesthetics before needle insertion, as needle EMG testing can be quite painful, especially for children. Remarkably, they suggested comparing the pain experience with that of venipuncture, yet acknowledged that ".…”

“…I read with interest the article by Alshaikh and colleagues. 1 In their study they performed a prospective investigation of pediatric patients undergoing nerve conduction studies (NCS) and needle electromyography (EMG). They found that the pain recorded fell within the moderate range on the scoring systems they used, with 66% of the patients describing a level of pain equivalent to or less than that of venipuncture.…”

“….most blood tests in children are now conducted after application of local anesthetics." 1 Raveh and colleagues 2 demonstrated that pain induced by both needle insertion and local injection was significantly diminished after topical application of a eutectic mixture of local anesthetics (lidocaine/prilocaine, or EMLA cream). However, they also noted that part of the effect was placebo, as a placebo ointment (petroleum jelly) also produced significant pain alleviation.…”