Pain during lumbar puncture: a 2 year discussion at the Société francaise d'oncologie pédiatrique. Background. — Lumbar puncture is a common procedure in pediatric onco-hematology. Repeated invasive painful procedures may contribute to increase distress displayed during medical treatment, and cause regression, depression and other psychological disorders. Material and methods. — A two-year workshop of the Société française d'oncologie pédiatrique was reviewed through a questionnaire assessing changes in technical management of lumbar puncture, local anesthesia, sedation and cognitive-behavioral interventions. Results. — Significant changes were found for pain assessment, local anesthesia procedures, and nitrous oxide administration. The extensive use of the Emla ® cream largely contributed to reduce pain. Anxiety however remained an unsolved problem, particularly among young children. Conclusion. — Pain in pediatrics remains a major challenge. This workshop is a model of reflexion to achieve a better management of pain during invasive medical procedures.
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