Don’t use physical restraint as a first choice during painful procedures in children
Often, to perform invasive procedures and/or to position devices, we resort to the physical restraint of the child, with insufficient explanation of what will happen, and without an appropriate analgesic coverage. Missing pain control and anxiety management generate rejection, crying, anguish, stress, non-compliance in the little patient and worry and anxiety in his/her parents. In addition to the well known conventional procedures, there are valid alternative methods, such as: comfortable position of the baby, controlled breathing, distraction and encouragement of mother and child, simulation of a story through puppets and, in particular, audiovisual techniques that better influence the cognitive-emotional component of pain. The use of local anesthetics such as lidocaine cream / patch / powder can be taken into account depending on the duration of the procedures. The pain and associated discomfort control for diagnostic / therapeutic procedures is effective in reducing the child’s reactions to painful events that should occur over time and can foster the acceptance of any other type of future care intervention.
1. Bartolozzi G: Attenuazione del dolore da venipuntura nel bambino. Medico e Bambino pagine elettroniche 2008; 11(9.).
2. Zempsky WT, Bean-Lijewski J, Kauffman RE et al: Needle-free powder lidocaine delivery system provides rapid effective analgesia for venipuncture or cannulation pain in children: randomized, double-blind comparison of venipuncture and venous cannulation pain after fast-onset needle-free powder lidocaine or placebo treatment trial. Pediatrics 2008; 121(5): 979-87.
3. William T. Zempsky: Management of Peripheral Venous Access Pain in Children: Evidence, Impact, and Implementation. Pediatrics. November 2008, VOLUME 122 / ISSUE Supplement 3.
4. Lessi E: Il dolore da venipuntura nel bambino: il beneficio della distrazione con audiovisivi; Società italiana di scienze infermieristiche pediatriche; 2011.
5. Lysakowski C1, Dumont L, Tramèr MR, Tassonyi E. A needle-free jet-injection system with lidocaine for peripheral intravenous cannula insertion: a randomized controlled trial with cost-effectiveness analysis. PubMED. Anesth Analg. 2003 Jan; 96(1): 215-9.
6. Perricone G, Di Maio MT, Nuccio FR: Raccontando Aladino - vincoli e possibilità del lavoro psico-socio-educativo in pediatria. Milano: Franco Angeli Edizioni. 2008. 7. “Il dolore nel bambino” - Ministero della Salute. www.salute.gov.it/imgs/C_17_pubblicazioni_1256_allegato.pdf
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.