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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2002 September;68(9):695-703

language: English

Pain control during diagnostic and/or therapeutic procedures in children

Astuto M. 1, Favara-Scacco C. 3, Crimi E. 2, Rizzo G. 1, Di Cataldo A. 3

1 Department of Anesthesia and Care Unit University of Cata­nia, Cata­nia
2 Department of Anesthesia and Intensive Care Unit, ­University of East Piedmont “Amedeo Avogadro”, Nova­ra
3 Regional Center of Paediatric Haematology and Oncology, Azien­da Pol­i­clin­i­co, University of Cata­nia, Cata­nia, Italy


­Children’s ­fear of ­pain in ill­ness has ­been great­ly under­es­ti­mat­ed. In can­cer dis­ease, ­pain char­ac­teriz­es ­most of the diag­nos­tic and ­long-­term ther­a­peu­tic pro­ce­dures. ­Children’s psy­cho-emo­tion­al pro­cess­ing dur­ing ill­ness has ­been recent­ly rec­og­nized as char­ac­ter­ized by ­loss of con­trol, ­anger, and ­fear, to ­which ­pain ­adds ­fear of ­death jeop­ard­iz­ing the ­sense of sur­vi­val. Ill­ness and ­pain pro­voke a trau­mat­ic con­di­tion affect­ing psy­cho-emo­tion­al mat­u­ra­tion. The aim of the phar­mac­o­log­ic and psy­cho­log­ic sup­port is to ­help chil­dren bet­ter ­cope ­with ­pain and pre­vent the ­healed ­child hav­ing trau­mat­ic ­effects in his/her ­future per­son­al­ity struc­ture and behav­ior. To ­assure the ­best ­pain con­trol, sup­port has to be ­offered ­right ­from the ­first intru­sive pro­ce­dure in ­order to ­avoid antic­i­pa­to­ry anx­ie­ty. Res­pi­ra­tion, relax­a­tion, vis­u­al­iza­tion, desen­si­bil­iza­tion ­through the “switch tech­nique” and the “mag­ic ­glove”, dis­trac­tion and involve­ment, mus­cu­lar relax­a­tion all ­have the com­mon aim of focus­ing the ­child’s ­mind and atten­tion ­away ­from ­body per­cep­tion of ­pain con­nect­ed to the pro­ce­dure. Dif­fer­ent med­i­cal meth­ods are uti­lized depend­ing on the ­child’s age and the lev­el of con­scious­ness ­required for the pro­ce­dure. ­Local anaesthe­sia and con­scious seda­tion are ­used. Chil­dren are par­tic­u­lar­ly sen­si­tive in ­this crit­i­cal con­di­tion and ­need as ­serene and com­fort­able an envi­ron­ment as pos­sible. ­Relief of ­pain and suf­fer­ing in can­cer treat­ments ­that ­cause fur­ther dis­com­fort to the ­patient is a fun­da­men­tal eth­ics in the treat­ment of clin­i­cal neo­pla­sias.

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