Journal of developmental and behavioral pediatrics : JDBP
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J Dev Behav Pediatr · Aug 1999
Clinimetric evaluation of the pain observation scale for young children in children aged between 1 and 4 years after ear, nose, and throat surgery.
This study assessed the reliability, validity, and responsiveness of a new pain measure for children aged 1 to 4 years that was developed from the Children's Hospital of Ontario Pain Scale and its Neonatal Infant Pain Scale. Pain in 311 children, aged 1 to 4 years, was measured by two observers at fixed intervals after adenotonsillectomy (n = 114), adenotomy (n = 109), or insertion of ventilation tubes (grommets) (n = 88) until discharge using a dichotomous pain scale of 9 behavioral and physiological categories. ⋯ On these final 7 items, the ability to distinguish between patients with differing degrees of pain and the sensitivity to detect changes over time within each patient were substantial. The resulting Pain Observation Scale for Young Children is reliable and easy to use for assessment of short- and longer-lasting pain after ear, nose, and throat surgery and may be used for assessing pain with other conditions.
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J Dev Behav Pediatr · Aug 1999
Randomized Controlled Trial Clinical TrialManagement of pain from heel lance with lidocaine-prilocaine (EMLA) cream: is it safe and efficacious in preterm infants?
Hospitalized preterm infants undergo multiple painful heel lances. A two-phase, randomized, controlled trial was undertaken to determine the safety and efficacy of lidocaine-prilocaine 5% cream (EMLA, Astra Pharmaceuticals, L. P, Westborough, MA) for relieving pain from heel lance. ⋯ The mean methemoglobin concentration was 1.19% (.47). Approximately 10% of infants had minor skin reactions, and approximately 20% of EMLA-treated infants had blanching at the application site. The authors conclude that EMLA is safe but not efficacious for relieving pain from heel lance in preterm infants.
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Although there is a rich body of research on the development of children's memory for the details of personally experienced events, relatively little is known about age-related changes in the ability to remember pain. This gap in the literature is surprising, given that studies of children's memory for painful experiences are relevant to our basic understanding of cognitive development, pain perception, and--in some situations--patient management. ⋯ Nonetheless, the authors recognize that this framework will no doubt need to be modified to take into account the complex memory representations--containing somatosensory, affective, and contextual information--that are established after exposure to painful stimulation. After the treatment of the literature, the authors discuss its implications for the clinical management of pain in pediatric settings.