Blowing Away the Pain: A Technique for Pediatric Pain Management

Jacobs, Adrian; Price, Harper; Popenhagen, Mark

doi:10.1111/pde.12418

Cited by 9 publications

(11 citation statements)

References 6 publications

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“…Children belonging to Group 2 (Intervention group), however, appeared more relaxed in the second appointment during local anaesthetic infiltration with greater reduction in the mean dental anxiety scores, as compared to the control group, although this was not statistically significant. The bubble breath exercise prevents the initial response of holding the breath due to the pain stimulus, thus preventing the heightening of the pain sensation, thereby promoting relaxation . Other factors influencing dental anxiety such as temperament, personality factors, and the coping abilities of the child, however, may have influenced the outcome .…”

Section: Discussionmentioning

confidence: 99%

“…Thus in this study, though dental anxiety remained comparable even after the relaxation exercise, the exercise may have served as coping technique, thus decreasing the pain perception. The exercise also helped in effectively distracting the child, by shifting the attention of the child away from the source of pain, when the child was engaged in deep breathing, as if blowing bubble breaths . Thus, distraction may have resulted in decreasing the pain response.…”

Section: Discussionmentioning

confidence: 99%

“…A daily chart was given to the children as a reminder to perform the exercise. Parents were engaged to assist as coaches who incited their children to practise the exercise at home, ensuring that the correct technique of breathing and blowing the air out was being followed …”

Section: Methodsmentioning

confidence: 99%

“…In order to reduce procedural pain and anxiety, cognitive behavioural techniques such as distraction, relaxation strategies, and coping mechanisms have been widely studied. These approaches are founded on the gate‐control theory of pain, which suggests that the descending signals due to thoughts, emotions, and attention may influence the ascending signals of pain . Distraction is a technique that takes away the focus of the child from painful stimuli by engaging other senses.…”

Section: Introductionmentioning

confidence: 99%

“…Distraction is a technique that takes away the focus of the child from painful stimuli by engaging other senses. The bubble breath exercise is a deep breathing exercise that has been used as a distraction strategy to manage pain in very young children . It has been used as an effective distraction strategy for paediatric pain management during short procedures like immunizations, cryotherapy of dermal warts and also to decrease pain perception in children with chronic conditions like epidermolysis bullosa, and cancer …”

Section: Introductionmentioning

confidence: 99%

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Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial

Sridhar

Suprabha

Shenoy

et al. 2019

Int J Paed Dentistry

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Background Cognitive behavioural techniques can decrease procedural pain and anxiety in children. Bubble breath exercise, a play therapy technique, may be used as a relaxation strategy to manage anxiety and pain. The objective of the study was to evaluate the effect of bubble breath exercise on dental anxiety, dental behaviour, and pain intensity during buccal infiltration of local anaesthetic in children. Study Design This randomized controlled trial involved 66 children aged 7‐11 years, randomly allocated to two groups: Group 1 (control) and Group 2 (intervention group). Group 2 was trained in bubble breath exercise. The reaction during buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl's behaviour rating scale), anxiety (Facial Image Scale and pulse rate), and pain perception (Wong‐Baker FACES pain rating scale and the Faces, Leg, Activity, Cry, and Consolability scale). Results The bubble breath exercise significantly reduced the pain perceived, as measured by both the Wong‐Baker FACES pain rating scale (P < 0.001) and the FLACC scale (P < 0.001). There was no statistically significant difference in dental anxiety and behaviour among the groups. Conclusion Use of bubble breath exercise may be beneficial in decreasing the pain perceived during maxillary buccal infiltration anaesthesia in 7‐ to 11‐year‐old children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial

Sridhar

Suprabha

Shenoy

et al. 2019

Int J Paed Dentistry

View full text Add to dashboard Cite

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Complications of Surgery and Invasive Procedures

Cohen¹,

Price

2019

Pediatric Dermatologic Surgery

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Could a careful clinical examination distinguish physiologic phimosis from balanitis xerotica obliterans in children?

et al. 2020

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The diagnosis of balanitis xerotica obliterans (BXO) in children may be challenging, since clinical examination only could lead to an underestimation of its incidence. The aim of this retrospective and single-centre study is to assess the diagnostic performance of clinical examination, together with clinical history, in identifying BXO. Ninety-seven children underwent circumcision for phimosis from 2015 to 2019. Histology was routinely performed. Cohen’s kappa coefficient, sensitivity, specificity, predictive values, likelihood ratios and accuracy of macroscopic appearance of the foreskin, steroid administration and past medical history were estimated. Forty-eight patients (50%) were affected by BXO; 31 of them (69%) presented with suggestive clinical signs. A strictured or whitish urethral meatus was detected during surgery in nine cases (19%); this was associated to allergic or immune diseases (p = 0.046). Foreskin appearance alone mildly correlated with histology (k = 0.494; p < 0.001) and it showed a diagnostic accuracy of 75%. The specificity and positive predictive value of abnormal macroscopic findings at examination, together with a positive clinical history for other allergic or immune diseases, and/or for balanitis, were 100% and the positive likelihood ratio was greater than 10. Conversely, sensitivity decreased to 4.5% (95% CI 0–11%).Conclusion: Foreskin appearance together with clinical history could predict BXO with certainty. However, since the absence of a positive medical history could not exclude the diagnosis, foreskin histology is still highly recommended. What is Known:• Occurrence of balanitis xerotica obliterans may be underestimated in children and it could lead to long-term complications.• The diagnostic accuracy of clinical examination is controversial. What is New:• Clinical signs together with patients’ medical history present high specificity and positive predictive values but low sensitivity.• When suggestive clinical aspects are present, patient should be referred to surgery avoiding prolonged conservative treatment; and preputial histology is highly recommended.

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Blowing Away the Pain: A Technique for Pediatric Pain Management

Cited by 9 publications

References 6 publications

Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial

Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial

Complications of Surgery and Invasive Procedures

Could a careful clinical examination distinguish physiologic phimosis from balanitis xerotica obliterans in children?

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