@article {10821, title = {Needle-related pain and distress management during needle-related procedures in children with and without intellectual disability.}, journal = {Eur J Pediatr}, volume = {177}, year = {2018}, month = {2018 Dec}, pages = {1753-1760}, abstract = {

Children with intellectual disability frequently undergo needle-related procedures for diagnosis or treatment. Nevertheless, only a few studies deal with pain and distress management during the procedure in this population of children. This study aimed to investigate the number of anxiety and pain management techniques performed during needle procedure in children with intellectual disability (cases) compared to a population of children without intellectual disability (controls). This multicenter cohort study was performed from July 2016 to January 2018 in the pediatric ward of four urban hospitals in Italy. Eligible subjects were children with and without intellectual disability, from 4 to 17~years old, who needed venipuncture or intravenous cannulation for diagnosis or treatment. Use of topical anesthesia, distraction techniques, and physical or verbal comfort during procedures were recorded. Pain and anxiety scores were also recorded. Forty-seven cases and 94 controls were recruited. Three pain- and anxiety-relieving techniques were performed during the procedure in 12 (25\%) cases and in 10 controls (11\%); two techniques were performed in 23 (50\%) cases and in 26 (28\%) controls; 12 (25\%) cases and 52 (55\%) controls received only one.Conclusion: In this series, children with intellectual disability received significantly more relieving techniques, but experienced more pain and anxiety when compared to children without intellectual disability. What is Known: {\textbullet} Children with intellectual disability experience more episodes of pain than cognitively healthy ones, and almost 10\% of these episodes are due to medical procedures. What is New: {\textbullet} Children with intellectual disability despite receiving more relieving techniques during a needle-related procedure experienced more pain and anxiety when compared to healthy children.

}, keywords = {Adolescent, Anxiety, Child, Child, Preschool, Cohort Studies, Female, Humans, Intellectual Disability, Italy, Male, Pain Management, Pain Measurement, Pain, Procedural, Phlebotomy}, issn = {1432-1076}, doi = {10.1007/s00431-018-3237-4}, author = {Pascolo, Paola and Peri, Francesca and Montico, Marcella and Funaro, Mishelle and Parrino, Roberta and Vanadia, Francesca and Rusalen, Francesca and Vecchiato, Luca and Benini, Franca and Congedi, Sabrina and Barbi, Egidio and Cozzi, Giorgio} } @article {10536, title = {First-time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream.}, journal = {Acta Paediatr}, volume = {106}, year = {2017}, month = {2017 May}, pages = {773-778}, abstract = {

AIM: More than 50\% of children report apian during venepuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream.

METHODS: We conducted this multicentre randomised controlled trial at three tertiary-level children{\textquoteright}s hospitals in Italy in 2015. Children aged three to 10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt.

RESULTS: The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4\%) who received the warm patch and in 142 children (85.0\%) who received the cream (p = 0.03). The pain scores were similar in both groups.

CONCLUSION: This study showed that the first-time needle procedure success was 7.4\% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream.

}, keywords = {Anesthetics, Local, Catheterization, Peripheral, Child, Child, Preschool, Female, Hot Temperature, Humans, Lidocaine, Lidocaine, Prilocaine Drug Combination, Male, Pain, Phlebotomy, Prilocaine, Tetracaine}, issn = {1651-2227}, doi = {10.1111/apa.13764}, author = {Cozzi, Giorgio and Borrometi, Fabio and Benini, Franca and Neri, Elena and Rusalen, Francesca and Celentano, Loredana and Zanon, Davide and Schreiber, Silvana and Ronfani, Luca and Barbi, Egidio} }