Table of Contents Author Guidelines Submit a Manuscript
Advances in Urology
Volume 2008, Article ID 498614, 12 pages
http://dx.doi.org/10.1155/2008/498614
Review Article

Anxiety in Children Undergoing VCUG: Sedation or No Sedation?

Department of Paediatrics, Starship Children's Hospital, University of Auckland, Private Bag 92024, Auckland, New Zealand

Received 9 January 2008; Accepted 14 May 2008

Academic Editor: Walid A. Farhat

Copyright © 2008 David W. Herd. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. D. A. Bergman, R. D. Baltz, and J. R. Cooley, “Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children,” Pediatrics, vol. 103, no. 4, part 1, pp. 843–852, 1999. View at Google Scholar
  2. D. G. Bundy, “Vesicoureteral reflux,” Pediatrics in Review, vol. 28, no. 2, pp. e6–e8, 2007. View at Publisher · View at Google Scholar
  3. J. S. Elder, H. M. Snyder, C. Peters et al., “Variations in practice among urologists and nephrologists treating children with vesicoureteral reflux,” The Journal of Urology, vol. 148, no. 2, part 2, pp. 714–717, 1992. View at Google Scholar
  4. J. C. Craig, L. M. Irwig, J. F. Knight, and L. P. Roy, “Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy?” Pediatrics, vol. 105, no. 6, pp. 1236–1241, 2000. View at Publisher · View at Google Scholar
  5. W. C. Faust and H. G. Pohl, “Role of prophylaxis in vesicoureteral reflux,” Current Opinion in Urology, vol. 17, no. 4, pp. 252–256, 2007. View at Publisher · View at Google Scholar
  6. E. H. Garin and L. Young, “Much pain, little gain from voiding cystourethrogram after urinary tract infection,” Pediatrics, vol. 120, no. 1, pp. 249–250, 2007. View at Publisher · View at Google Scholar
  7. E. M. Hodson, D. M. Wheeler, D. Vimalchandra, G. H. Smith, and J. C. Craig, “Interventions for primary vesicoureteric reflux,” Cochrane Database of Systematic Reviews, no. 3, article CD001532, 2007. View at Publisher · View at Google Scholar
  8. T. B. Newman, “Much pain, little gain from voiding cystourethrograms after urinary tract infection,” Pediatrics, vol. 118, no. 5, p. 2251, 2006. View at Publisher · View at Google Scholar
  9. K. V. Jones, “Time to review the value of imaging after urinary tract infection in infants,” Archives of Disease in Childhood, vol. 90, no. 7, pp. 663–664, 2005. View at Publisher · View at Google Scholar
  10. E. R. Wald, “Vesicoureteral reflux: the role of antibiotic prophylaxis,” Pediatrics, vol. 117, no. 3, pp. 919–922, 2006. View at Publisher · View at Google Scholar
  11. E. R. Wald, “Much pain, little gain from voiding cystourethrograms after urinary tract infection: in reply,” Pediatrics, vol. 118, no. 5, pp. 2251–2252, 2006. View at Publisher · View at Google Scholar
  12. S. Agrawalla, R. Pearce, and T. R. Goodman, “How to perform the perfect voiding cystourethrogram,” Pediatric Radiology, vol. 34, no. 2, pp. 114–119, 2004. View at Publisher · View at Google Scholar
  13. D. Phillips, A. R. Watson, and J. Collier, “Distress and radiological investigations of the urinary tract in children,” European Journal of Pediatrics, vol. 155, no. 8, pp. 684–687, 1996. View at Publisher · View at Google Scholar
  14. D. A. Phillips, A. R. Watson, and D. MacKinlay, “Distress and the micturating cystourethrogram: does preparation help?” Acta Paediatrica, vol. 87, no. 2, pp. 175–179, 1998. View at Publisher · View at Google Scholar
  15. E. E. Stashinko and J. Goldberger, “Test or trauma? The voiding cystourethrogram experience of young children,” Issues in Comprehensive Pediatric Nursing, vol. 21, no. 2, pp. 85–96, 1998. View at Publisher · View at Google Scholar
  16. K. Hjelm-Karlsson, “Dispelling the fear of the unknown. Effects of information to patients undergoing urography,” Acta Radiologica, Supplement, vol. 375, part 2, pp. 7–29, 1991. View at Google Scholar
  17. S. M. Jay and C. H. Elliott, “A stress inoculation program for parents whose children are undergoing painful medical procedures,” Journal of Consulting and Clinical Psychology, vol. 58, no. 6, pp. 799–804, 1990. View at Publisher · View at Google Scholar
  18. S. M. Jay, C. H. Elliott, M. Ozolins, R. A. Olson, and S. D. Pruitt, “Behavioral management of children's distress during painful medical procedures,” Behaviour Research and Therapy, vol. 23, no. 5, pp. 513–520, 1985. View at Publisher · View at Google Scholar
  19. L. Kuttner, “Management of young children's acute pain and anxiety during invasive medical procedures,” Pediatrician, vol. 16, no. 1-2, pp. 39–44, 1989. View at Google Scholar
  20. E. V. Lang, E. G. Benotsch, L. J. Fick et al., “Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial,” The Lancet, vol. 355, no. 9214, pp. 1486–1490, 2000. View at Publisher · View at Google Scholar
  21. E. V. Lang, J. S. Joyce, D. Spiegel, D. Hamilton, and K. K. Lee, “Self-hypnotic relaxation during interventional radiological procedures: effects on pain perception and intravenous drug use,” International Journal of Clinical and Experimental Hypnosis, vol. 44, no. 2, pp. 106–119, 1996. View at Publisher · View at Google Scholar
  22. S. L. Manne, W. H. Redd, P. B. Jacobsen, K. Gorfinkle, O. Schorr, and B. Rapkin, “Behavioral intervention to reduce child and parent distress during venipuncture,” Journal of Consulting and Clinical Psychology, vol. 58, no. 5, pp. 565–572, 1990. View at Publisher · View at Google Scholar
  23. T. Piira, T. Sugiura, G. D. Champion, N. Donnelly, and A. S. J. Cole, “The role of parental presence in the context of children's medical procedures: a systematic review,” Child: Care, Health and Development, vol. 31, no. 2, pp. 233–243, 2005. View at Google Scholar
  24. U. Pretzlik and K. Sylva, “Paediatric patients' distress and coping: an observational measure,” Archives of Disease in Childhood, vol. 81, no. 6, pp. 528–530, 1999. View at Google Scholar
  25. U. Pretzlik and K. Sylva, “Paediatric patients' distress and coping during medical treatment: a self report measure,” Archives of Disease in Childhood, vol. 81, no. 6, pp. 525–527, 1999. View at Google Scholar
  26. B. K. Stephens, M. E. Barkey, and H. R. Hall, “Techniques to comfort children during stressful procedures,” Accident and Emergency Nursing, vol. 7, no. 4, pp. 226–236, 1999. View at Publisher · View at Google Scholar
  27. N. Zelikovsky, J. R. Rodrigue, and C. A. Gidycz, “Reducing parent distress and increasing parent coping-promoting behavior during children's medical procedure,” Journal of Clinical Psychology in Medical Settings, vol. 8, no. 4, pp. 273–281, 2001. View at Publisher · View at Google Scholar
  28. N. Zelikovsky, J. R. Rodrigue, C. A. Gidycz, and M. A. Davis, “Cognitive behavioral and behavioral interventions help young children cope during a voiding cystourethrogram,” Journal of Pediatric Psychology, vol. 25, no. 8, pp. 535–543, 2000. View at Publisher · View at Google Scholar
  29. R. E. Kauffman, W. Banner Jr., C. M. Berlin et al., “Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures,” Pediatrics, vol. 89, no. 6, part 1, pp. 1110–1115, 1992. View at Google Scholar
  30. J. B. Gross, P. L. Bailey, R. A. Caplan et al., “Practice guidelines for sedation and analgesia by non-anesthesiologists: a report by the American Society of Anesthesiologists Task Force on sedation and analgesia by non-anesthesiologists,” Anesthesiology, vol. 84, no. 2, pp. 459–471, 1996. View at Publisher · View at Google Scholar
  31. R. Gorman, B. A. Bates, W. E. Benitz et al., “Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: addendum,” Pediatrics, vol. 110, no. 4, pp. 836–838, 2002. View at Publisher · View at Google Scholar
  32. C. J. Coté, H. W. Karl, D. A. Notterman, J. A. Weinberg, and C. McCloskey, “Adverse sedation events in pediatrics: analysis of medications used for sedation,” Pediatrics, vol. 106, no. 4, pp. 633–644, 2000. View at Publisher · View at Google Scholar
  33. C. J. Coté, D. A. Notterman, H. W. Karl, J. A. Weinberg, and C. McCloskey, “Adverse sedation events in pediatrics: a critical incident analysis of contributing factors,” Pediatrics, vol. 105, no. 4, part 1, pp. 805–814, 2000. View at Publisher · View at Google Scholar
  34. K. Salmon and J. K. Pereira, “Predicting children's response to an invasive medical investigation: the influence of effortful control and parent behavior,” Journal of Pediatric Psychology, vol. 27, no. 3, pp. 227–233, 2002. View at Publisher · View at Google Scholar
  35. J. P. Boswinkel and R. S. Litman, “Sedating patients for radiologic studies,” Pediatric Annals, vol. 34, no. 8, pp. 650–656, 2005. View at Google Scholar
  36. B. Krauss and S. M. Green, “Sedation and analgesia for procedures in children,” The New England Journal of Medicine, vol. 342, no. 13, pp. 938–945, 2000. View at Publisher · View at Google Scholar
  37. B. Krauss and S. M. Green, “Procedural sedation and analgesia in children,” The Lancet, vol. 367, no. 9512, pp. 766–780, 2006. View at Publisher · View at Google Scholar
  38. “Safe Sedation of Children Undergoing Diagnostic and Therapeutic Procedures: A national clinical guideline (SIGN 58),” http://www.sign.ac.uk/guidelines/fulltext/58/index.html.
  39. “Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical or Surgical Procedures. Australia and New Zealand College of Anaesthetists. Available at,” http://www.anzca.edu.au/resources/professional-documents/professional-standards/ps9.html. Accessed 26 June 2008.
  40. C. J. Coté, S. Wilson, P. Casamassimo et al., “Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update,” Pediatrics, vol. 118, no. 6, pp. 2587–2602, 2006. View at Publisher · View at Google Scholar
  41. I. Akil, M. Ozkol, O. Y. Ikizoglu et al., “Premedication during micturating cystourethrogram to achieve sedation and anxiolysis,” Pediatric Nephrology, vol. 20, no. 8, pp. 1106–1110, 2005. View at Publisher · View at Google Scholar
  42. L. D. Butler, B. K. Symons, S. L. Henderson, L. D. Shortliffe, and D. Spiegel, “Hypnosis reduces distress and duration of an invasive medical procedure for children,” Pediatrics, vol. 115, no. 1, pp. e77–e85, 2005. View at Publisher · View at Google Scholar
  43. J. S. Elder and R. Longenecker, “Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy,” American Journal of Roentgenology, vol. 164, no. 5, pp. 1229–1232, 1995. View at Google Scholar
  44. R. M. Ellerkmann, J. S. Dunn, A. W. McBride et al., “A comparison of anticipated pain before and pain rating after the procedure in patients who undergo cystourethroscopy,” American Journal of Obstetrics and Gynecology, vol. 189, no. 1, pp. 66–69, 2003. View at Publisher · View at Google Scholar
  45. D. W. Herd, K. A. McAnulty, N. A. Keene, and D. E. Sommerville, “Conscious sedation reduces distress in children undergoing voiding cystourethrography and does not interfere with the diagnosis of vesicouteric reflux: a randomized controlled study,” American Journal of Roentgenology, vol. 187, no. 6, pp. 1621–1626, 2006. View at Publisher · View at Google Scholar
  46. A. Kadioglu, “Voiding cystourethrography: sedation or no sedation?” Pediatric Radiology, vol. 34, no. 1, p. 90, 2004. View at Publisher · View at Google Scholar
  47. I. Keidan, R. Zaslansky, M. Weinberg et al., “Sedation during voiding cystourethrography: comparison of the efficacy and safety of using oral midazolam and continuous flow nitrous oxide,” The Journal of Urology, vol. 174, no. 4, part 2, pp. 1598–1601, 2005. View at Publisher · View at Google Scholar
  48. P. A. Merguerian, S. T. Corbett, and J. Cravero, “Voiding ability using propofol sedation in children undergoing voiding cystourethrograms: a retrospective analysis,” The Journal of Urology, vol. 176, no. 1, pp. 299–302, 2006. View at Publisher · View at Google Scholar
  49. J. Oswald, M. Riccabona, L. Lusuardi, H. Ulmer, G. Bartsch, and C. Radmayr, “Voiding cystourethrography using the suprapubic versus transurethral route in infants and children: results of a prospective pain scale oriented study,” The Journal of Urology, vol. 168, no. 6, pp. 2586–2589, 2002. View at Publisher · View at Google Scholar
  50. M. Robinson, J. Savage, M. Stewart, and L. Sweeney, “The diagnostic value, parental and patient acceptability of micturating cysto-urethrography in children,” Irish Medical Journal, vol. 92, no. 5, pp. 366–368, 1999. View at Google Scholar
  51. T. Srivastava, G. Betts, A. R. Rosenberg, and G. Kainer, “Perception of fear, distress and pain by parents of children undergoing a micturating cystourethrogram: a prospective study,” Journal of Paediatrics and Child Health, vol. 37, no. 3, pp. 271–273, 2001. View at Publisher · View at Google Scholar
  52. E. Stokland, S. Andréasson, B. Jacobsson, U. Jodal, and B. Ljung, “Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study,” Pediatric Radiology, vol. 33, no. 4, pp. 247–249, 2003. View at Google Scholar
  53. E. C. Bjørkholen, C. Ø. Gravdahl, and I. H. Vandvik, “Micturating cystourethrography: are the practical routines in accordance with empirical knowledge?” Tidsskrift for den Norske Laegeforening, vol. 125, no. 12, pp. 1689–1691, 2005 (Norwegian). View at Google Scholar
  54. E. Chen, “Commentary: the role of memory in managing children's distress during medical procedures,” Journal of Pediatric Psychology, vol. 31, no. 8, pp. 862–864, 2006. View at Publisher · View at Google Scholar
  55. J. S. Elder, “Imaging for vesicoureteral reflux—is there a better way?” The Journal of Urology, vol. 174, no. 1, pp. 7–8, 2005. View at Publisher · View at Google Scholar
  56. J. Madzik, A. Marcinski, M. Brzewski et al., “Midazolam administration at a department of pediatric radiology: conscious sedation for diagnostic imaging studies,” Polish Journal of Radiology, vol. 71, no. 2, pp. 93–96, 2006 (Polish). View at Google Scholar
  57. C. Radmayr, “Can hypnosis reduce distress and improve compliance with voiding cystourethrogram in children?” Nature Clinical Practice Urology, vol. 2, no. 4, pp. 162–163, 2005. View at Publisher · View at Google Scholar
  58. P. Schmit and M. Sfez, “Pain and stress in pediatric uroradiology: efficacy of a specific protocol,” Journal de Radiologie, vol. 78, no. 5, pp. 367–372, 1997. View at Google Scholar
  59. J. L. Zier, K. A. Kvam, S. C. Kurachek, and M. Finkelstein, “Sedation with nitrous oxide compared with no sedation during catheterization for urologic imaging in children,” Pediatric Radiology, vol. 37, no. 7, pp. 678–684, 2007. View at Publisher · View at Google Scholar
  60. “Guideline statement: management of procedure-related pain in children and adolescents,” Journal of the Paediatrics and Child Health, vol. 42, supplement 1, pp. S1–S29, 2006.
  61. M. Bosio, “Cystosonography with echocontrast: a new imaging modality to detect vesicoureteric reflux in children,” Pediatric Radiology, vol. 28, no. 4, pp. 250–255, 1998. View at Publisher · View at Google Scholar
  62. P. Bozkurt, N. Kiliç, G. Kaya, Y. Yeker, M. Eliçevik, and Y. Söylet, “The effects of intranasal midazolam on urodynamic studies in children,” British Journal of Urology, vol. 78, no. 2, pp. 282–286, 1996. View at Google Scholar
  63. C. J. Coté, “Round and round we go: sedation—what is it, who does it, and have we made things safer for children?” Paediatric Anaesthesia, vol. 18, no. 1, pp. 3–8, 2008. View at Publisher · View at Google Scholar
  64. M. J. Diament and P. Stanley, “The use of midazolam for sedation of infants and children,” American Journal of Roentgenology, vol. 150, no. 2, pp. 377–378, 1987. View at Google Scholar
  65. E. H. Garin, F. Olavarria, V. G. Nieto, B. Valenciano, A. Campos, and L. Young, “Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study,” Pediatrics, vol. 117, no. 3, pp. 626–632, 2006. View at Publisher · View at Google Scholar
  66. L. L. Gerard, C. S. Cooper, K. S. Duethman, B. M. Gordley, and C. M. Kleiber, “Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization,” The Journal of Urology, vol. 170, no. 2, part 1, pp. 564–567, 2003. View at Publisher · View at Google Scholar
  67. S. Hansson, M. Dhamey, O. Sigström et al., “Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection,” The Journal of Urology, vol. 172, no. 3, pp. 1071–1073, 2004. View at Publisher · View at Google Scholar
  68. K. Ilan, R. Zaslansky, and M. Weinberg, “Sedation during voiding cystourethrography: comparison of the efficacy and safety of using oral midazolam and continuous-flow nitrous oxide,” in Section on Urology, American Academy of Pediatrics, San Francisco, Calif, USA, October 2004. View at Google Scholar
  69. C. Kleiber and A. M. McCarthy, “Parent behavior and child distress during urethral catheterization,” Journal of the Society of Pediatric Nurses, vol. 4, no. 3, pp. 95–104, 1999. View at Google Scholar
  70. B. Ljung and S. Andréasson, “Comparison of midazolam nasal spray to nasal drops for the sedation of children,” Journal of Nuclear Medicine Technology, vol. 24, no. 1, pp. 32–34, 1996. View at Google Scholar
  71. G. Ljungman, A. Kreuger, S. Andréasson, T. Gordh, and S. Sörensen, “Midazolam nasal spray reduces procedural anxiety in children,” Pediatrics, vol. 105, no. 1, part 1, pp. 73–78, 2000. View at Publisher · View at Google Scholar
  72. K. A. Merritt, P. A. Ornstein, and B. Spicker, “Children's memory for a salient medical procedure: implications for testimony,” Pediatrics, vol. 94, no. 1, pp. 17–23, 1994. View at Google Scholar
  73. J. A. Quas, G. S. Goodman, S. Bidrose, M.-E. Pipe, S. Craw, and D. S. Ablin, “Emotion and memory: children's long-term remembering, forgetting, and suggestibility,” Journal of Experimental Child Psychology, vol. 72, no. 4, pp. 235–270, 1999. View at Publisher · View at Google Scholar
  74. J. N. Rubenstein, M. Maizels, S. C. Kim, and J. T. B. Houston, “The PIC cystogram: a novel approach to identify “occult” vesicoureteral reflux in children with febrile urinary tract infections,” The Journal of Urology, vol. 169, no. 6, pp. 2339–2343, 2003. View at Publisher · View at Google Scholar
  75. K. Salmon, F. McGuigan, and J. K. Pereira, “Brief report: Optimizing children's memory and management of an invasive medical procedure: the influence of procedural narration and distraction,” Journal of Pediatric Psychology, vol. 31, no. 5, pp. 522–527, 2006. View at Publisher · View at Google Scholar
  76. K. Salmon, M. Price, and J. K. Pereira, “Factors associated with young children's long-term recall of an invasive medical procedure: a preliminary investigation,” Journal of Developmental and Behavioral Pediatrics, vol. 23, no. 5, pp. 347–352, 2002. View at Google Scholar
  77. P. Schmit and M. Sfez, “Management of anxious and painful manifestations in pediatric uroradiology,” Journal of Radiology, vol. 78, no. 5, pp. 367–372, 1997 (French). View at Google Scholar
  78. J. Smellie, D. Edwards, N. Hunter, I. C. S. Normand, and N. Prescod, “Vesico ureteric reflux and renal scarring,” Kidney International, vol. 8, pp. S65–S72, 1975. View at Google Scholar
  79. M. Stein, D. Lubetkin, H. C. Taub, W. K. Skinner, J. Haberman, and E. R. Kreutzer, “The effects of intraurethral lidocaine anesthetic and patient anxiety on pain perception during cystoscopy,” The Journal of Urology, vol. 151, no. 6, pp. 1518–1521, 1994. View at Google Scholar
  80. E. Stokland, S. Andréasson, B. Jacobsson, U. Jodal, and B. Ljung, “Voiding cystourethrography: sedation or no sedation?: in reply,” Pediatric Radiology, vol. 34, no. 1, p. 91, 2004. View at Publisher · View at Google Scholar
  81. M. Thompson, S. D. Simon, V. Sharma, and U. S. Alon, “Timing of follow-up voiding cystourethrogram in children with primary vesicoureteral reflux: development and application of a clinical algorithm,” Pediatrics, vol. 115, no. 2, pp. 426–434, 2005. View at Publisher · View at Google Scholar
  82. O. M. Sobczak, “General anesthesia in outpatient pediatric uroradiology,” Anesthesia & Analgesia, vol. 51, no. 6, pp. 910–913, 1972. View at Publisher · View at Google Scholar
  83. E. Webb and W. E. Goodwin, “Anesthesia for voiding cystourethrograms in pediatric patients,” The Journal of Urology, vol. 110, no. 2, pp. 259–260, 1973. View at Google Scholar
  84. H. Weiss and G. Badlani, “Effects of anesthesia on micturition and urodynamics,” International Anesthesiology Clinics, vol. 31, no. 1, pp. 1–24, 1993. View at Publisher · View at Google Scholar
  85. J. R. Woodard and G. Filardi, “The demonstration of vesicoureteral reflux under general anesthesia,” The Journal of Urology, vol. 116, no. 4, pp. 501–502, 1976. View at Google Scholar
  86. A. R. Jadad, R. A. Moore, D. Carroll et al., “Assessing the quality of reports of randomized clinical trials: is blinding necessary?” Controlled Clinical Trials, vol. 17, no. 1, pp. 1–12, 1996. View at Publisher · View at Google Scholar
  87. J. Cooper, D. Jobling, and D. H. Edmunds, “Sedation for minor oral surgery: inhalation sedation with 25 per cent nitrous oxide,” Journal of Dentistry, vol. 6, no. 3, pp. 265–267, 1978. View at Publisher · View at Google Scholar
  88. M. T. Hosey and A. S. Blinkhorn, “An evaluation of four methods of assessing the behaviour of anxious child dental patients,” International Journal of Paediatric Dentistry, vol. 5, no. 2, pp. 87–95, 1995. View at Google Scholar
  89. K. G. Bis and T. L. Slovis, “Accuracy of ultrasonic bladder volume measurement in children,” Pediatric Radiology, vol. 20, no. 6, pp. 457–460, 1990. View at Publisher · View at Google Scholar
  90. G. B. Humphrey, C. M. J. Boon, G. F. van Linden van den Heuvell, and H. B. M. van de Wiel, “The occurrence of high levels of acute behavioral distress in children and adolescents undergoing routine venipunctures,” Pediatrics, vol. 90, no. 1, part 1, pp. 87–91, 1992. View at Google Scholar
  91. S. I. Merkel, T. Voepel-Lewis, J. R. Shayevitz, and S. Malviya, “The FLACC: a behavioral scale for scoring postoperative pain in young children,” Pediatric Nursing, vol. 23, no. 3, pp. 293–297, 1997. View at Google Scholar
  92. S. M. Jay and C. Elliott, “Behavioral observation scales for measuring children's distress: the effects of increased methodological rigor,” Journal of Consulting and Clinical Psychology, vol. 52, no. 6, pp. 1106–1107, 1984. View at Publisher · View at Google Scholar
  93. D. Wheeler, D. Vimalachandra, E. M. Hodson, L. P. Roy, G. Smith, and J. C. Craig, “Antibiotics and surgery for vesicoureteric reflux: a meta-analysis of randomised controlled trials,” Archives of Disease in Childhood, vol. 88, no. 8, pp. 688–694, 2003. View at Publisher · View at Google Scholar
  94. S. N. Oak, B. Kulkarni, and N. Chaubal, “Color flow Doppler sonography: a reliable alternative to voiding cystourethrogram in the diagnosis of vesicoureteral reflux in children,” Urology, vol. 53, no. 6, pp. 1211–1214, 1999. View at Publisher · View at Google Scholar
  95. A. H. Colodny and R. L. Lebowitz, “The importance of voiding during a cystourethrogram,” The Journal of Urology, vol. 111, no. 6, pp. 838–839, 1974. View at Google Scholar
  96. A. Arsanjani and M. Alagiri, “Identification of filling versus voiding reflux as predictor of clinical outcome,” Urology, vol. 70, no. 2, pp. 351–354, 2007. View at Publisher · View at Google Scholar
  97. P. A. McGrath, “Commentary: psychological interventions for controlling children's pain: challenges for evidence-based medicine,” Journal of Pediatric Psychology, vol. 24, no. 2, pp. 172–174, 1999. View at Publisher · View at Google Scholar
  98. C. J. Coté, ““Conscious sedation”: time for this oxymoron to go away!,” Journal of Pediatrics, vol. 139, no. 1, pp. 15–17, 2001. View at Publisher · View at Google Scholar
  99. M. Golparvar, M. Saghaei, P. Sajedi, and S. S. Razavi, “Paradoxical reaction following intravenous midazolam premedication in pediatric patients—a randomized placebo controlled trial of ketamine for rapid tranquilization,” Paediatric Anaesthesia, vol. 14, no. 11, pp. 924–930, 2004. View at Publisher · View at Google Scholar
  100. T. A. Thurston, C. G. A. Williams, and S. L. Foshee, “Reversal of a paradoxical reaction to midazolam with flumazenil,” Anesthesia & Analgesia, vol. 83, no. 1, p. 192, 1996. View at Publisher · View at Google Scholar
  101. J. C. Sanders, “Flumazenil reverses a paradoxical reaction to intravenous midazolam in a child with uneventful prior exposure to midazolam,” Paediatric Anaesthesia, vol. 13, no. 4, pp. 369–370, 2003. View at Publisher · View at Google Scholar
  102. C. L. Tucker, K. J. Slifer, and L. M. Dahlquist, “Reliability and validity of the brief behavioral distress scale: a measure of children's distress during invasive medical procedures,” Journal of Pediatric Psychology, vol. 26, no. 8, pp. 513–523, 2001. View at Publisher · View at Google Scholar
  103. D. L. Wong and C. M. Baker, “Pain in children: comparison of assessment scales,” Pediatric Nursing, vol. 14, no. 1, pp. 9–17, 1988. View at Google Scholar
  104. B. J. Anderson and G. M. Palmer, “Recent pharmacological advances inpaediatric analgesics,” Biomedicine and Pharmacotherapy, vol. 60, no. 7, pp. 303–309, 2006. View at Publisher · View at Google Scholar
  105. D. W. Herd and B. Salehi, “Palatability of two forms of paracetamol (acetaminophen) suspension: a randomised trial,” Paediatric and Perinatal Drug Therapy, vol. 7, no. 4, pp. 189–193, 2006. View at Publisher · View at Google Scholar
  106. B. Stevens, J. Yamada, and A. Ohlsson, “Sucrose for analgesia in newborn infants undergoing painful procedures,” Cochrane Database of Systematic Reviews, no. 3, article CD001069, 2004. View at Publisher · View at Google Scholar
  107. D. Crellin, T. P. Sullivan, F. E. Babl, R. O'Sullivan, and A. Hutchinson, “Analysis of the validation of existing behavioral pain and distress scales for use in the procedural setting,” Paediatric Anaesthesia, vol. 17, no. 8, pp. 720–733, 2007. View at Publisher · View at Google Scholar
  108. M. Borland, I. Jacobs, B. King, and D. O'Brien, “A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department,” Annals of Emergency Medicine, vol. 49, no. 3, pp. 335–340, 2007. View at Publisher · View at Google Scholar
  109. J.-M. Malinovsky, L. Le Normand, J.-Y. Lepage et al., “The urodynamic effects of intravenous opioids and ketoprofen in humans,” Anesthesia & Analgesia, vol. 87, no. 2, pp. 456–461, 1998. View at Publisher · View at Google Scholar
  110. S. Malviya, T. Voepel-Lewis, and A. R. Tait, “Adverse events and risk factors associated with the sedation of children by nonanesthesiologists,” Anesthesia & Analgesia, vol. 85, no. 6, pp. 1207–1213, 1997. View at Publisher · View at Google Scholar