Purpose: The use of topical Lidocaine creams (e.g., EMLA™) prior to intravenous (IV) insertion does not prevent pain for some children. Prior research shows that approximately 1/2 of children report significant pain despite the correct use of topical anesthetics. To develop effective pain prevention interventions, predictive variables must be identified. The purpose of this study is to identify variables that explain the variation in children’s pain. Conceptual Framework: Perceived pain is an interaction of physiological, psychological and developmental elements. Age, gender, previous experience, temperament, anxiety and genotype have been identified as potential contributors to increased pain sensitivity in children. Methods: A cross-sectional correlational design is used. This poster reports on 100 children enrolled thus far in a larger study on interventions for pain relief. Subjects are children with a chronic illness between the ages of 4 and 10 who are scheduled for an IV insertion for treatment or diagnostic reasons. EMLA is applied per standard protocol one hour prior to the IV procedure. The child’s perception of pain is the dependent variable and is measured with the “Oucher” scale (0 to 10) immediately after the IV procedure. Independent variables are the child’s age, gender, genotype, estimated number of painful procedures previously experienced, temperament as measured with the Dimensions of Temperament Scale-Revised, and child state anxiety as measured with a vertical 0 to 10 semantic descriptive scale. Blood and cheek swabs are collected for DNA extraction and genotyping of variants within three genes that are hypothesized to play a role in peripheral pain mediation: Endothelin 1, Endothelin Receptor B1, and Endothelin Receptor A. Plan of analysis: Multiple regression models will be used to select the best set of predictors of ineffective pain prevention related to the use of topical anesthetics for IV insertion. Key words: children, pain, Lidocaine
Session #1219 - Poster Session I
The 29th Annual MNRS Research Conference (April 1-4, 2005)