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Review
. 2016 Jan-Feb;31(1):e23-32.
doi: 10.1016/j.pedn.2015.09.002. Epub 2015 Sep 28.

The Assessment and Non-Pharmacologic Treatment of Procedural Pain From Infancy to School Age Through a Developmental Lens: A Synthesis of Evidence With Recommendations

Susan E Thrane  1 , Shannon Wanless  2 , Susan M Cohen  3 , Cynthia A Danford  3
Affiliations
Review

The Assessment and Non-Pharmacologic Treatment of Procedural Pain From Infancy to School Age Through a Developmental Lens: A Synthesis of Evidence With Recommendations

Susan E Thrane et al. J Pediatr Nurs. 2016 Jan-Feb.

Abstract

The 2011 IOM report stated that pain management in children is often lacking especially during routine medical procedures. The purpose of this review is to bring a developmental lens to the challenges in assessment and non-pharmacologic treatment of pain in young children.

Method: A synthesis of the findings from an electronic search of PubMed and the university library using the keywords pain, assessment, treatment, alternative, complementary, integrative, infant, toddler, preschool, young, pediatric, and child was completed. A targeted search identified additional sources for best evidence.

Results: Assessment of developmental cues is essential. For example, crying, facial expression, and body posture are behaviors in infancy that indicate pain: however in toddlers these same behaviors are not necessarily indicative of pain. Preschoolers need observation scales in combination with self-report while for older children self-report is the gold standard. Pain management in infants includes swaddling and sucking. However for toddlers, preschoolers and older children, increasingly sophisticated distraction techniques such as easily implemented non-pharmacologic pain management strategies include reading stories, watching cartoons, or listening to music.

Discussion: A developmental approach to assessing and treating pain is critical. Swaddling, picture books, or blowing bubbles are easy and effective when used at the appropriate developmental stage and relieve both physical and emotional pain. Untreated pain in infants and young children may lead to increased pain perception and chronic pain in adolescents and adults. Continued research in the non-pharmacological treatment of pain is an important part of the national agenda.

Keywords: Child; Child development; Infant; Non-pharmacologic interventions; Pain assessment and management.

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Figures

Figure 1
Figure 1
Article Flow Diagram *Articles are not mutually exclusive. Many sources reported on more than one topic area.
Figure 2
Figure 2
Wong-Baker FACES Pain Scale (From Hockenberry, M. J., Wilson, D., Winkelstein, M.L. (2005). Wong’s Essentials of Pediatric Nursing, 7th Ed., St. Louis, MO:Mosby, p. 1259. Used with permission. Copyright Mosby).
See this image and copyright information in PMC

References

    1. Anand KJ International Evidence-Based Group for Neonatal P. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med. 2001;155(2):173–180. - PubMed
    1. Bembich S, Davanzo R, Brovedani P, Clarici A, Massaccesi S, Demarini S. Functional neuroimaging of breastfeeding analgesia by multichannel near-infrared spectroscopy. Neonatology. 2013;104(4):255–259. doi: 10.1159/000353386. - DOI - PubMed
    1. Benjamin L. Pain management in sickle cell disease: palliative care begins at birth? American Society of Hematology Educational Program. 2008:466–474. doi: 10.1182/asheducation-2008.1.466. - DOI - PubMed
    1. Blount RL, Corbin SM, Sturges JW, Wolfe VV, Prater JM, James D. The relationship between adults’ behavior and chil coping and distress during BMA/LP procedures: A sequential analysis. Behavior Therapy. 1989;20(4):585–601. doi: 10.1016/S0005-7894(89)80136-4. - DOI
    1. Bringuier S, Picot MC, Dadure C, Rochette A, Raux O, Boulhais M, Capdevila X. A prospective comparison of post-surgical behavioral pain scales in preschoolers highlighting the risk of false evaluations. Pain. 2009;145(1–2):60–68. doi: 10.1016/j.pain.2009.05.012. - DOI - PubMed

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