Faces Pain Rating Scale Research Articles

Comparative evaluation of pain perception by vibrating needle (VibrajectTM) and conventional syringe anesthesia during various dental procedures in pediatric patients: A short study

Background: One of the most important and challenging aspects of behavior management in children during dental treatment is pain control. Fear related behavior has long been recognized as the most difficult aspect of patient management and can be a barrier to good care. Administration of local anesthesia may evoke anxiety not only in the patients but also in the clinicians. Although local anesthesia is most commonly used for pain control in dentistry, researches are going to seek new and better means of managing pain. In this study, we have used a newer vibration device named Vibraject™ to give painless anesthesia. Materials and Methods: 20 children aged between 8 and 14 years, visited the Department of Pedodontics, K.D. Dental College and Hospital, Mathura, for some dental treatment were selected. In the first appointment, local anesthesia using a conventional syringe was administered. The procedure was repeated with Vibraject™ on the opposite side of the same dental arch on the subsequent visit. The child side of the same dewas assessed through visual analog scale (VAS) and faces pain rating scale (FRS) for both the techniques. Various physiological parameters were also assessed and compared between conventional and vibrating injection techniques. Results: A statistically significant difference in VAS and FRS was found between the two techniques whereas when physiological parameters (heart rate, blood pressure, and temperature) were compared at various intervals, the difference was not statistically significant. Conclusion: Vibraject provides less pain while giving local anesthetic injections in comparison to the conventional injection technique in clinical dental procedures.

A Quasi-Experimental Study to assess the effectiveness of Cartoon Animation Movie on Pain During Intravenous Cannulation among Children at Pediatric Ward of Selected Hospitals, Jalandhar, Punjab, 2014

A Quasi-Experimental study was conducted on children of 5–12 years of age who were undergoing intravenous cannulation with gauze 22 at selected hospitals of Jalandhar, Punjab. The study comprised of 60 children selected by purposive sampling technique- 30 in experimental group and 30 in control group. Animated cartoon movie was shown during intravenous cannulation for experimental group and no animated cartoon movie was shown during intravenous cannulation for control group. Then the post pain score was assessed. The tool included was base line proforma- Wong-Baker Faces Pain Rating Scale. The results revealed that there is significantly (p<0.05) less pain felt by the children who viewed animated cartoon movie during intravenous cannulation than those children who did not receive it. The findings also revealed that there was no significant association between the level of pain and demographic variables. It was concluded that cartoon distraction is an effective distraction method for the children undergoing venipuncture.

Assessment of Post-operative Pain and the Activities that Increases Pain among Patients Undergoing Gastrectomy

Pain is one of the most common experiences and stressors in patients undergoing G.I. Surgeries. Patients undergoing gastrectomy may experience frequent and moderate to severe pain postoperatively. The incidence and severity of pain and a multimodal approach (use of a combination of pain control strategies including opiods, NSAIDS, non-pharmacologic intervention) to acute post gastrectomy pain is recommended. The present study was undertaken to assess the level of pain experienced by patients after gastrectomy, to identify the post-operative activities that increases pain and to find out the association between pain score of patients and the selected variables. A descriptive research design was adopted. Setting was Hi-Tech Medical college and Hospital. Sample size was 40 and convenient sampling technique was used. Wong Bakers faces pain rating scale and a validated questionnaire was used as a tool. The maximum obtainable pain score was 19. t-tests showed that the mean pain score on the second post operative day was significantly less then that of first post operative day. Chisquare test reveals that there is significant association between different degrees of pain and the selected demographic variables.

Perceived Pain during Cataract Surgery with Topical Anesthesia: A Comparison between First-Eye and Second-Eye Surgery.

Purpose. To compare pain scores between first-eye and second-eye cataract surgery and to determine the affecting factors. Methods. 106 first-eye and 53 second-eye cataract surgery patients (mean age: 67 ± 13 and 69 ± 10 years, resp.) were enrolled. The patients completed simplified State-Trait Anxiety Inventory and visual analog scale (VAS) for anxiety questionnaires before surgery, and VAS for pain and Wong-Baker Faces Pain Rating Scale questionnaires after surgery. Blood pressure (BP) and heart rate (HR) were recorded perioperatively. Results. A greater proportion of patients who underwent second-eye surgery reported intraoperative pain compared with first-eye surgery patients (85% versus 35%, P < 0.001). The pain scores were higher in second-eye surgery, while the VAS anxiety score was lower in second-eye surgery. Moreover, 31 patients reported greater pain during second-eye surgery than their first one, with higher pain scores than other 22 patients (P = 0.032 and 0.003, resp.). The VAS pain score of these 31 patients was positively correlated with the differences between the intraoperative and postoperative diastolic BP, mean arterial pressure, and HR. Conclusions. Cataract patients were likely to have more pain during second-eye surgery, which may be related to lower preoperative anxiety. Monitoring perioperative BP and HR may help to identify patients with intraoperative pain.

Induction with Propofol Decreases Emergence Agitation in Pediatric Patients

Background and objectives: Emergence agitation (EA) is a common complication seen after inhalational anesthesia especially with sevoflurane, with an incidence of 20-80%. The hypothesis of the study was that induction with propofol reduces the incidence and severity of emergence agitation when compared with sevoflurane in children undergoing inguinal hernia surgery. Methods: 116 Children undergoing inguinal hernia were randomly assigned to two groups: Sevoflurane group received sevoflurane increasing concentrations up to 8% and propofol group received 3 mg kg propofol in induction. Postoperative agitation treatment and analgesia was standardized, and postoperative assessments included Cole Agitation Scale and narcotic consumption for agitation, Wong-Baker Faces Pain Rating Scale for pain, first spontaneous eye opening time, first verbal command follow time, post-anesthesia care unit (PACU) staying time, first analgesic requirement time and parents satisfaction. Results: The incidence of EA at arrival in PACU and the cumulative incidences at the end of the postoperative two hours were significantly lower in the propofol group. EA scores were lower in propofol group in all measurement times during postoperative 30 minutes. Fentanyl consumption at arrival in PACU and the sum of the two hours were significantly lower in propofol group. Pain scores were lower in propofol group in the postoperative 24 hours. First analgesic requirement time and parents satisfaction were higher in propofol group. Conclusion: Propofol in accurate dose is effective in reducing the incidence and intense of EA in children undergoing inguinal hernia and maybe preferred in children with high risk of EA.

A comparative evaluation of per rectal diclofenac sodium and paracetamol for postoperative analgesia in case of hydrocephalus

Background: Hydrocephalus is one of the most painful conditions, especially in pediatric population. Analgesia after neurosurgery requires good communication and close cooperation between members of the perioperative team. Diclofenac is a nonsteroidal anti-inflammatory drug with pronounced antirheumatic, anti-inflammatory, analgesic, and antipyretic properties. Diclofenac inhibits prostaglandin synthesis, which contributes to inflammation, pain, and fever. Paracetamol produces analgesia and antipyresis by a mechanism similar to that of salicylate, which involves inhibition of prostaglandin synthesis. Objectives: To compare the analgesic efficacy of rectally administered diclofenac sodium and paracetamol postoperatively in patients with hydrocephalus for postoperative pain relief. Also, to compare side effects of both the drugs. Materials and Methods: Fifty patients aged 1-8 years scheduled for ventriculoperitoneal shunt under general anesthesia were selected for the study. All the patients were divided into two groups, Group D and Group P. At the end of surgery, 15 min before extubation, patients of Group D were rectally administered with inj. diclofenac 1 mg/kg whereas those of Group P with inj. paracetamol 15 mg/kg. Pain was assessed using Wong–Baker Faces Pain Rating Scale (WBFPS). When the score was 4 or more, then inj. paracetamol 15 mg/kg was administered intravenously as rescue analgesia. Patients were also observed for duration and analgesia. We have also compared hemodynamic parameters and complications in both the groups postoperatively. Results: Heart rate and SpO2 were stable in after the operation. Pain score on WBFPS was statistically nonsignificant between both the groups. Duration of analgesia was significantly longer in Group D than in Group P. Incidence of side effects and complications were also comparable in both the groups. Conclusion: We conclude that both paracetamol and diclofenac are very well tolerated by rectal route with prolonged duration of analgesia with diclofenac for postoperative pain relief in pediatric patients with hydrocephalus.

Can pain influence the proprioception and the motor behavior in subjects with mild and moderate knee osteoarthritis?

BackgroundOsteoarthritis (OA) is a chronic disease, usually characterized by pain, which is associated with reduced muscle strength, disability and progressive loss of function. However, the pain influence over proprioception and motor behaviour remains unclear. Thus, the purpose of the study was to identify the levels of pain, the proprioceptive acuity and the pattern of muscle recruitment during stair ascent and descent in elderly patients with mild and moderate osteoarthritis (OA) compared to healthy subjects.MethodsThe study participants included 11 healthy elderly subjects (7 women and 4 men) and 31 elderly patients with knee OA (19 women and 12 men). The functional capacity was assessed by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; the pain was evaluated by Wong-Baker faces pain rating scale (WBS) and pressure pain threshold (PPT); the proprioceptive acuity was based on the joint position sense evaluated by electrogoniometer; and the electromyographic (EMG) activity of the major muscles of the lower limb were evaluated during a task of stair ascent and descent of 15 cm. For statistical analysis it was used Statistic for Windows software (StatSoft Inc., version 5.0). Data from the WOMAC index, WBS, the proprioceptive acuity and IEMG (for each muscle in each phase) were analyzed using the Mann–Whitney U test and data from PPT was used Kruskal-Wallis test.ResultsHigher scores were found in the WOMAC index and WBS whereas lower scores were seen in PPT in patients with knee OA compared to healthy subjects. In contrast, there were no significant differences in the proprioceptive acuity and EMG results of most muscles analyzed between the groups.ConclusionThe presence of pain does not influence the proprioception and the motor behavior of the thigh muscles during stair ascent and descent in subjects with mild and moderate knee OA.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-321) contains supplementary material, which is available to authorized users.

Evaluation of pain during hysterosalpingography with the use of balloon catheter vs metal cannula

Our aim was to investigate the use of a balloon catheter device in comparison with metal cannula for hysterosalpingography (HSG) in terms of patient comfort. A total of 168 patients were randomised for HSG either with a balloon catheter (n = 83) or metal cannula (n = 85). Scores of pelvic pain during insertion of the devices, injection of the contrast medium and 1 h after the procedure were evaluated using the Wong Baker Faces Pain Rating Scale; complications and reinsertion rates were also noted. The pain scores were significantly lower in the balloon catheter group (p < 0.001). The reinsertion rate of metal cannula was higher (8.2% vs 2.4%) as well as the incidence of nausea being the most common short-term adverse effect (14.1% vs 1.2%) in the metal cannula group (p = 0.002). Performing HSG with a balloon catheter is advantageous for decreasing the pain and side-effects related to the procedure, when compared with the use of a metal cannula.

Art and Music Programs Prove Their Worth

Art and Music Programs Prove Their Worth

Dorsal penile nerve block for robot-assisted radical prostatectomy catheter related pain: a randomized, double-blind, placebo-controlled trial

PurposeFollowing Robotic-Assisted Radical Prostatectomy (RARP) patients routinely have penile pain and urethral discomfort secondary to an indwelling urethral catheter. Our objective was to assess the effect of dorsal penile nerve block with bupivacaine on urethral catheter-related pain after RARP.MethodsFrom 2012–2013, 140 patients with organ-confined prostate cancer were enrolled in an IRB approved double-blinded, randomized control trial comparing a dorsal penile nerve block of bupivacaine versus placebo after RARP performed by a single-surgeon. Patients were asked to complete questionnaires using the Wong-Bakers FACES Pain Rating scale while hospitalized and for 9 days post-operatively, until the catheter was removed. The primary end-points were: catheter-related discomfort, abdominal (incisional) pain, and bladder spasm-related discomfort. Secondary end-points included narcotic and other analgesic usage.Results120 patients were randomized to placebo vs. bupivacaine dorsal penile nerve bock. The two arms (n = 56 bupivacaine and n = 60 placebo) did not differ in preoperative, perioperative, or pathological results. There was no difference in narcotic utilization between the two cohorts. Abdominal pain was slightly lower in the bupivacaine arm at 6 hours compared to the placebo arm, but there was no difference in abdominal pain at other time points, and there were no differences in reported catheter-related discomfort or bladder spasm-associated discomfort at any of the measured time points.ConclusionsThe data does not support the routine use of a dorsal penile nerve block with bupivacaine following RARP.

Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study

The aim of our study was to analyze the possible relationship between growing pains, vitamin D levels, and bone mineral status. We enrolled 33 children affected by growing pains. Their pain intensity was evaluated through a questionnaire using the Wong-Baker Faces Pain Rating Scale for pain assessment. Serum 25-hydroxyvitamin D (25-OH-D), parathyroid hormone (PTH), and alkaline phosphatase levels were measured as well. A quantitative ultrasound assessment (QUS) was also done, measuring both the amplitude-dependent speed of sound (AD-SOS) and the bone transmission time (BTT), correlating, respectively, with bone density and with cortical thickness. After 3 and 24months of vitamin D supplementation, we re-evaluated pain intensity and laboratory results. After 24months we re-assessed QUS parameters. At the beginning of the study the children reported a mean growing pain intensity of 7.5±1.6 SD. The mean values of 25-OH-D and PTH levels were 15.7±6.9ng/ml and 57.3±27.3pg/ml, respectively. The AD-SOS Z score was -0.53±1.19 SD, and the mean value of the BTT Z score was -0.72±0.96 SD. After the first 3months of vitamin D supplementation we observed an increase in 25-OH-D levels (34.1±17.8, p<0.001) and a reduction in both PTH levels (47.3±30.6, p=0.135) and pain intensity (2.7±2.2, p<0.001). After 24months we observed a further significant reduction in the pain intensity (3.9±3.4, p<0.001) and in PTH levels (43.7±28.5, p=0.004) and an improvement in the QUS parameters, in particular in BTT Z scores (p=0.014). Our study suggests an interesting relationship between growing pains, vitamin D levels and bone mineral status.

Peripheral Intravenous Injection Pain in Hospitalized Children

Purpose: The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children. Methods: A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0. Results: Younger patients showed higher pain response than older patients (F=33.87, p< .001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation. Conclusion: A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.

Spontaneous Rupture of Liver Haemangioma-A Case Report &amp; Review of Literature

Background: Abdominal hyperalgic syndrome in unresectable pancreatic cancer worsens the quality of patients' life. The goal of this article is to evaluate the feasibility of performing the left splanchnicectomy using a two trocar thoracoscopic approach. Material and Methods: One patient suffering from intractable pain due to unresectable pancreatic cancer (stage IV) with liver metastasis underwent thoracoscopic unilateral left splanchnicectomy. The procedure was performed using only two trocars, one of 10 mm for the optic and one 5 mm working trocar for Hook electrocautery, scissors and grasper. To assess pain severity and the impact of this palliative procedure for pain relief, the patient completed Wong-Baker Faces Pain Rating Scale with a preoperative pain degree of 9. Results: Surgical procedure time was 30 minutes. Pleural drainage tube was removed 24 hours postoperatively. There were no complications. Immediate pain relief (pain degree 0 to 2) was achieved after thoracoscopic unilateral splanchnicectomy, same level beeing registered at first checkup after one month. Conclusions: Thoracoscopic unilateral left splanchnicectomy using two trocars is feasible in selected cases, decreasing substantial the pain and significantly improving the quality of life in patients with unresectable pancreatic cancer.

Thoracoscopic Left Splanchnicectomy: Two Trocar Technique

Background: Abdominal hyperalgic syndrome in unresectable pancreatic cancer worsens the quality of patients' life. The goal of this article is to evaluate the feasibility of performing the left splanchnicectomy using a two trocar thoracoscopic approach. Material and Methods: One patient suffering from intractable pain due to unresectable pancreatic cancer (stage IV) with liver metastasis underwent thoracoscopic unilateral left splanchnicectomy. The procedure was performed using only two trocars, one of 10 mm for the optic and one 5 mm working trocar for Hook electrocautery, scissors and grasper. To assess pain severity and the impact of this palliative procedure for pain relief, the patient completed Wong-Baker Faces Pain Rating Scale with a preoperative pain degree of 9. Results: Surgical procedure time was 30 minutes. Pleural drainage tube was removed 24 hours postoperatively. There were no complications. Immediate pain relief (pain degree 0 to 2) was achieved after thoracoscopic unilateral splanchnicectomy, same level beeing registered at first checkup after one month. Conclusions: Thoracoscopic unilateral left splanchnicectomy using two trocars is feasible in selected cases, decreasing substantial the pain and significantly improving the quality of life in patients with unresectable pancreatic cancer.

Comparative Evaluation of the Efficacy of Topical Anesthetics in Reducing Pain during Administration of Injectable Local Anesthesia in Children

ABSTRACTIntroductionPain control is an integral part of modern dentistry. Needle injection of local anesthetic which is the commonest modality of pain control itself proves to be painful for the child. Hence, it is important for the pediatric dentists to resort to a pain free method of administering local anesthesia for a patient. Topical anesthetics have proven to reduce the pain experience during administration of local anesthetic injection. The aim of this study is to evaluate and compare the efficacy of two topical anesthetic agents—EMLA 5% cream (Eutectic mixture of local anesthetics—Lignocaine 2.5% and prilocaine 2.5%) and Benzocaine 20% gel in reducing the pain during administration of local anesthetic injection in children.Materials and methodsEMLA 5% cream and Benzocaine 20% gel were used in the study. Children from mixed dentition age group between 6 and 9 years of age were selected. The two selected topical anesthetics were applied on buccal mucosa at two different appointments in a given child, following which the local anesthetic was administered on the test site. The pain responses of the child were evaluated using the Wong Baker Faces Pain Rating Scale. The results were then statistically analyzed using Mann-Whitney U-test.ResultsEMLA 5% cream was three times highly effective in pain reduction than Benzocaine 20% gel.ConclusionEMLA 5% cream is comparatively better than benzocaine 20% gel with regards to pain reduction during the administration of local anesthetic injection in children.How to cite this articleWalimbe H, Muchandi S, Bijle MNA, Bendgude V, Deshpande R, Dolas A, Chaturvedi S. Comparative Evaluation of the Efficacy of Topical Anesthetics in Reducing Pain during Administration of Injectable Local Anesthesia in Children. World J Dent 2014;5(2):129-133.

관심전환 중재가 영유아의 병원 공포와 주사통증에 미치는 효과

Purpose: This study attempted to discover the effects of distraction on the hospitalized children`s fear of the hospital and needle-related pain. Methods: The experimental group was given visual stimulation using a character from the injection room entrance. In addition, the video recording of `bambarabam` was provided for visual and auditory stimulation to distract the children. The research tools included the hospital-related fear scale, Faces Pain Rating Scale (Wong & Baker, 1988) and Procedure Behaviour Check List (Lebaron&Zeltzer, 1984). For statistical analysis, the SPSS 19.0 program was used on the collected data for -test and Mann-Whitney U test. Results: The experimental group showed significantly less fear ofthe hospital compared to the control group (U

FDG PET Uptake as a Predictor of Pain Response in Palliative Radiation Therapy in Patients with Bone Metastasis

Purpose To evaluate the relationship between fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) maximum standardized uptake value (SUVmax) and pain response to radiation therapy (RT) in patients with bone metastasis. Materials and Methods Institutional ethical board approval for the study was obtained, with informed consent, for this prospective study. Thirty-one patients with metastatic bone pain who underwent FDG PET/computed tomography before RT were included. Patients were diagnosed with lung (n = 16), breast (n = 7), stomach (n = 2), and head and neck cancers (n = 3), as well as unknown primary tumor (n = 3). Eighty-five painful metastatic locations with FDG PET scans geographically corresponding to 40 treatment fields were evaluated. Pain scores using visual analog scale or faces pain rating scale and SUVmax at each location were recorded. All patients were treated with a single fraction 8 Gy RT. Pain scores after RT were assessed at weeks 2, 4, 8, 12, 16, 20, and 24. The pretreatment pain scores and pain response to RT were compared with FDG PET SUVmax of each location. Pearson correlation, independent t test, one-way analysis of variance, and χ2 tests were used for statistical analysis. Results Median SUVmax and initial pain scores for all locations were 7.2 (range, 1.5–22.5) and 6 (range, 2–8), respectively. Median follow-up time was 24 (range, 3–112) weeks. Median SUVmax was 4.5 (range, 3.1–7.3), 4.75 (range, 1.5–10.3), 8.8 (range, 5.2–11.9), and 12.1 (range, 7–22.5) for pretreatment pain scores of 2, 4, 6, and 8, respectively. SUVmax was correlated with pretreatment pain scores (P < .0001). SUVmax and pretreatment pain scores were also significantly associated with pain response to RT. Median SUVmax for locations with complete response, partial response, pain progression, and indeterminate response was 5.2, 9.75, 10.8, and 6.4, respectively (P ≤ .001). Conclusion FDG PET SUVmax correlated with initial pain severity and pain response to RT and can be used as a predictive factor for treatment response in patients with painful bone metastasis treated with palliative RT. © RSNA, 2013

FDG PET Uptake as a Predictor of Pain Response in Palliative Radiation Therapy in Patients with Bone Metastasis

To evaluate the relationship between fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) maximum standardized uptake value (SUV(max)) and pain response to radiation therapy (RT) in patients with bone metastasis. Institutional ethical board approval for the study was obtained, with informed consent, for this prospective study. Thirty-one patients with metastatic bone pain who underwent FDG PET/computed tomography before RT were included. Patients were diagnosed with lung (n = 16), breast (n = 7), stomach (n = 2), and head and neck cancers (n = 3), as well as unknown primary tumor (n = 3). Eighty-five painful metastatic locations with FDG PET scans geographically corresponding to 40 treatment fields were evaluated. Pain scores using visual analog scale or faces pain rating scale and SUV(max) at each location were recorded. All patients were treated with a single fraction 8 Gy RT. Pain scores after RT were assessed at weeks 2, 4, 8, 12, 16, 20, and 24. The pretreatment pain scores and pain response to RT were compared with FDG PET SUV(max) of each location. Pearson correlation, independent t test, one-way analysis of variance, and χ(2) tests were used for statistical analysis. Median SUV(max) and initial pain scores for all locations were 7.2 (range, 1.5-22.5) and 6 (range, 2-8), respectively. Median follow-up time was 24 (range, 3-112) weeks. Median SUV(max) was 4.5 (range, 3.1-7.3), 4.75 (range, 1.5-10.3), 8.8 (range, 5.2-11.9), and 12.1 (range, 7-22.5) for pretreatment pain scores of 2, 4, 6, and 8, respectively. SUV(max) was correlated with pretreatment pain scores (P < .0001). SUV(max) and pretreatment pain scores were also significantly associated with pain response to RT. Median SUV(max) for locations with complete response, partial response, pain progression, and indeterminate response was 5.2, 9.75, 10.8, and 6.4, respectively (P ≤ .001). FDG PET SUV(max) correlated with initial pain severity and pain response to RT and can be used as a predictive factor for treatment response in patients with painful bone metastasis treated with palliative RT.

The effects of audiovisual distraction on children's pain during laceration repair

This study aimed to determine the effects of audiovisual distraction on pain in children during laceration repair in emergency room settings. This study was designed as a randomized controlled trial. Eighty‐four children aged 3–10 years were randomized to either the experimental group or the control group. Pain response was assessed by the Faces Pain Rating Scale, a visual analogue scale and the Procedure Behaviour Checklist. We measured salivary cortisol levels as a physiological pain response. The results showed that the sensory and affective pain responses were significantly lower in magnitude in the experimental group than in the control group. There was no statistically significant difference in physiological pain responses between the two groups. Audiovisual distraction might be a helpful method to reduce children's pain during laceration repair in emergency room settings.

Passive smoking increases pain perception in children undergoing venous catheterization

To establish whether there is any association between passive smoking and pain perception in children, in the absence of existing studies into possible links. This single-centre study focused on 100 children - 50 who had been exposed to passive smoking and 50 who had not - who were admitted to general polyclinics from September 2012 to December 2012 and needed venous catheterization. Patients with chronic diseases, neurologic and psychiatric illnesses, communication problems and analgesic use in the last 24h were excluded. The passive smoking group had a mean age of 7.3years (56% male) and the nonpassive smoking group had a mean age of 7.7years (44% male). The main study parameter was the Wong-Baker faces pain rating scale (WBFPS) score during catheterization. There was a statistically significant difference between the pain perceptions of the 100 children studied and smoke exposure. The WBFPS scores of the 50 children who were passive smokers were significantly higher than the scores of the 50 who were not passive smokers (p=0.00). Passive smoking increases pain perception in children during invasive medical procedures.