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Consequences of inadequate analgesia during painful procedures in children. Arch Pediatr Adolesc Med 1998 Feb;152(2):147-9



Pubmed ID





OBJECTIVE: To explore the effect of inadequate analgesia for painful procedures (bone marrow aspiration, lumbar puncture, or both) on the pain of subsequent procedures.

DESIGN: A cohort of patients with cancer who had participated in a placebo-controlled, randomized study that documented the efficacy of oral transmucosal fentanyl citrate for painful procedures rated the pain associated with subsequent procedures performed with open-label oral transmucosal fentanyl.

PARTICIPANTS: Twenty-one children undergoing diagnostic procedures who had been participants in previous study.

INTERVENTION: All children were given oral transmucosal fentanyl, 15 to 20 microgram/kg, prior to the procedure; at its conclusion they were asked to rate the associated pain.

RESULTS: In children younger than 8 years (n = 13), mean pain ratings during each subsequent procedure were consistently higher for those who had received placebo (n = 8) in the original study compared with those who had received the active drug (n = 5). A repeated-measures analysis of variance suggests that this difference is statistically significant (P = .04). Older children (n = 8) did not show this pattern.

CONCLUSION: Inadequate analgesia for initial procedures in young children may diminish the effect of adequate analgesia in subsequent procedures.

Author List

Weisman SJ, Bernstein B, Schechter NL


Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Oral
Analgesics, Opioid
Analysis of Variance
Bone Marrow Examination
Child, Preschool
Mouth Mucosa
Pain Measurement
Spinal Puncture
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d