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Pain Research and Management
Volume 13 (2008), Issue 1, Pages 51-57
http://dx.doi.org/10.1155/2008/465891
Review

Review of Systematic Reviews on Acute Procedural Pain in Children in the Hospital Setting

Jennifer Stinson,1 Janet Yamada,2 Alison Dickson,2 Jasmine Lamba,2 and Bonnie Stevens3

1Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Centre for Nursing and Department of Anesthesia, The Hospital for Sick Children, Toronto, Ontario, Canada
2Centre for Nursing and Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
3Lawrence S Bloomberg Faculty of Nursing and Faculty of Medicine, University of Toronto, Centre for Nursing and Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada

Copyright © 2008 Hindawi Publishing Corporation. 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.

Abstract

BACKGROUND: Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated.

OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children.

METHODS: Published systematic reviews and meta-analyses on pharmacological and nonpharmacological management of acute procedure-related pain in hospitalized children aged one to 18 years were evaluated. Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Two reviewers independently selected articles for review and assessed their quality using a validated seven-point quality assessment measure. Any disagreements were resolved by a third reviewer.

RESULTS: Of 1469 published articles on interventions for acute pain in hospitalized children, eight systematic reviews met the inclusion criteria and were included in the analysis. However, only five of these reviews were of high quality. Critical appraisal of pharmacological pain interventions indicated that amethocaine was superior to EMLA (AstraZeneca Canada Inc) for reducing needle pain. Distraction and hypnosis were nonpharmacological interventions effective for management of acute procedure-related pain in hospitalized children.

CONCLUSIONS: There is growing evidence of rigorous evaluations of both pharmacological and nonpharmacological strategies for acute procedure-related pain in children; however, the evidence underlying some commonly used strategies is limited. The present review will enable the creation of a future research plan to facilitate clinical decision making and to develop clinical policy for managing acute procedure-related pain in children.