Painful Pricks and Prickle Pains: Is There a Relation Between Children's Ratings of Venipuncture Pain and Parental Assessments of Usual Reaction to Other Pains?

Goodenough, Belinda; Perrott, David A.; Champion, G. David; Thomas, W

doi:10.1097/00002508-200006000-00007

Cited by 18 publications

(7 citation statements)

References 15 publications

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“…However, the judgements of parents in regard to acute pain (Schneider and LoBiondo Wood 1992) and longer-lasting pain (Miller 1996) more closely correspond to those of the children than do the judgements of health care professionals. Research also suggests that this correspondence is greater when parents rely on behavioral cues rather than on verbal reactions to pain (Goodenough et al 2000), something that caregivers of children with severe cognitive impairments are more likely to do because their children are generally non-verbal.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pain in children with severe cognitive impairments

Breau

Camfield

McGrath

et al. 2004

Develop Med Child Neuro

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Diagnosing cause of pain in children with severe cognitive impairments is difficult due to their problems with communication. Identification of risk factors for specific pain etiologies might help professionals in this task. The aim of this study was to determine whether child-related characteristics increase risk for specific types of pain. Participants were the caregivers of 41 females and 53 males with moderate to profound mental retardation, who were aged 3 to 18 years 8 months (mean 10:1, SD 4:4) but who communicated at the level of a typical child of 13.8 months (SD 10 months): 44 of the children had cerebral palsy (CP) and 59 a seizure disorder. Caregivers reported the cause of children's episodes of pain for four 1-week periods over 1 year. Logistic regression analyses were used to predict occurrence of specific types of pain using children's demographic, medical, and physical characteristics. Children had 406 episodes of pain due to accident, gastrointestinal conditions, musculoskeletal problems, infection, recurrent conditions, and common childhood causes. Results indicated that a unique set of risk factors predicted each pain type in this sample. Significant risk factors for pain included: lack of visual impairment and leg impairment (accidental pain); seizures, leg impairment, and greater number of medications (non-accidental pain); being male and tube fed (musculoskeletal pain); age <7 years, absence of CP, visual impairment, and less frequent medical monitoring (infection pain); being female and with arm impairment (gastrointestinal pain); and being tube fed and taking fewer medications (common childhood pains). In most cases, models were more specific than sensitive, indicating that the significant predictors are more useful for eliminating potential pain causes. These results suggest that population risk factors may be helpful in structuring diagnostic investigations for individual children with severe cognitive impairments.

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Section: Discussionmentioning

confidence: 99%

Risk factors for pain in children with severe cognitive impairments

Breau

Camfield

McGrath

et al. 2004

Develop Med Child Neuro

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“…Zsigmond 27 observed that zero pain scores were consistently observed in more than 100,000 persons who received jet injection of lidocaine (jet anesthesia), while other investigators have stated that jet injection is more painful than traditional needle injection. 5 Goodenough et al 28 reported that observed facial expression is more reliable in measuring pain intensity than self-reporting techniques. Apart from the mechanical properties of the skin site to be injected, pain sensitivity is affected by age, anxiety level, cultural background, and genetic traits as well as a wide range of interpersonal variability.…”

Section: Risks and Challengesmentioning

confidence: 99%

Current trends in needle-free jet injection: an update

Barolet¹,

Benohanian²

2018

CCID

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BackgroundJet injection can be defined as a needle-free drug delivery method in which a high-speed stream of fluid impacts the skin and delivers a drug. Despite 75 years of existence, it never reached its full potential as a strategic tool to deliver medications through the skin.ObjectiveThe aim of this review was to evaluate and summarize the evolution of jet injection intradermal drug delivery method including technological advancements and new indications for use.MethodsA review of the literature was performed with no limits placed on publication date.ResultsNeedleless injectors not only reduce pain during drug delivery but also confine the drug more evenly in the dermis. Understanding skin properties of the injection site is a key factor to obtain optimal results as well as setting the right parameters of the jet injector. Until the advent of disposable jet injectors/cartridges, autoclaving of the injector remains the only reliable method to eliminate the risk of infection. Needle-free intradermal injection using corticosteroids and/or local anesthetics is well documented with promising indications being developed.LimitationsLimitations of the review include low-quality evidence, small sample sizes, varying treatment parameters, and publication bias.ConclusionNew developments may help reconsider the use of jet injection technology. Future studies should focus on measurable optimized parameters to insure a safe and effective outcome.

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“…[1][2][3][4] Topical anesthetics such as EMLA (AstraZeneca, Wilmington, DE; a eutectic mixture of 2.5% lidocaine and 2.5% prilocaine) and L.M.X.4 (Ferndale Laboratories, Ferndale, MI; 4% lidocaine) have been shown to provide effective local anesthesia for venipuncture and intravenous cannulation. [5][6][7][8][9] However, a period of 30 to 90 minutes, depending on the product and the procedure, may be required between application and the onset of effect, limiting the usefulness of these products in busy health care settings and for emergency department applications.…”

mentioning

confidence: 99%

Rapid, Needle-Free Delivery of Lidocaine for Reducing the Pain of Venipuncture Among Pediatric Subjects

Migdał

Chudzynska-Pomianowska

Vause³

et al. 2005

Pediatrics

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ABSTRACT. Objectives. The purpose of this study was to determine the optimal configuration of an investigational, single-use, needle-free, drug system (ALGRX 3268) that delivers powdered lidocaine into the epidermis for the rapid production of local anesthesia among pediatric subjects undergoing venipuncture.Methods. Children 3 to 18 years of age were randomly allocated to receive 1 of 3 treatments, ie, (1) placebo, (2) a system configured to deliver 0.25 mg of lidocaine, or (3) a system configured to deliver 0.5 mg of lidocaine, at the antecubital fossa 2 to 3 minutes before venipuncture. Three age groups were included, ie, 3 to 7 years, 8 to 12 years, and 13 to 18 years. Two sets of pain rating scales were used, the Faces Pain Scale-Revised for the youngest age stratum and a visual analog scale for the oldest age stratum. Children in the middle age stratum used both scales.Results. One-hundred forty-four subjects completed the study. For all ages combined, there was a statistically significant and clinically meaningful reduction in pain scores for subjects who received 0.5 mg of lidocaine, compared with placebo. The reduction in pain after 0.25 mg of lidocaine did not achieve statistical significance.Conclusions. Both active configurations were safe and well tolerated by pediatric subjects undergoing venipuncture at the antecubital fossa. ALGRX 3268 at 0.5 mg, administered 2 to 3 minutes before venipuncture, produced significantly lower pain scores, compared with placebo. [5][6][7][8][9] However, a period of 30 to 90 minutes, depending on the product and the procedure, may be required between application and the onset of effect, limiting the usefulness of these products in busy health care settings and for emergency department applications. [9][10][11] The delivery of lidocaine to the skin through iontophoresis has also been investigated among children undergoing venipuncture or intravenous catheter insertion. 12,13 Iontophoretic lidocaine systems feature a controller and disposable, drug-saturated electrodes and use the application of an electric current to carry ionized lidocaine through the skin. 13 Lidocaine iontophoresis has been shown to be more effective than placebo in reducing the pain of venipuncture and to be comparable to EMLA for intravenous catheter placement. 12,13 However, studies indicate that lidocaine iontophoresis requires up to 15 minutes for onset of effect. 14 This study was undertaken to evaluate an investigational, needle-free, single-use, prefilled, disposable system (ALGRX 3268; AlgoRx Pharmaceuticals Inc, Secaucus, NJ) capable of delivering fine, dry, powdered lidocaine into the epidermis for the rapid production (within 1-3 minutes) of local anesthesia before venipuncture. The system is placed against the skin at the site of venipuncture and is triggered simply by pressing of the actuator button (Fig 1). Pressurized, medical-grade, helium gas within the system accelerates lidocaine particles to velocities sufficient to penetrate the outer skin layers and produce local anesthesia. ...

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Painful Pricks and Prickle Pains: Is There a Relation Between Children's Ratings of Venipuncture Pain and Parental Assessments of Usual Reaction to Other Pains?

Cited by 18 publications

References 15 publications

Risk factors for pain in children with severe cognitive impairments

Risk factors for pain in children with severe cognitive impairments

Current trends in needle-free jet injection: an update

Rapid, Needle-Free Delivery of Lidocaine for Reducing the Pain of Venipuncture Among Pediatric Subjects

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