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Published in: BMC Gastroenterology 1/2020

Open Access 01-12-2020 | Endoscopy | Research article

Age and pain score before gastrointestinal endoscopies in children are predictors for post procedure pain

Authors: Tut Galai, Anat Yerushalmy-Feler, Nathan P. Heller, Amir Ben-Tov, Yael Weintraub, Achiya Amir, Hadar Moran-Lev, Lilach Zac, Shlomi Cohen

Published in: BMC Gastroenterology | Issue 1/2020

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Abstract

Background

Gastrointestinal endoscopy may be associated with pain and anxiety. Predictors for high pain scores after endoscopies in children are not known. The aim of our study was to identify risk factors for prolonged recovery and higher pain scores after gastrointestinal endoscopy in children.

Methods

All the children that were electively admitted for gastrointestinal endoscopies were included. We retrospectively collected demographic, clinical and endoscopic data as well as information on the recovery process. A numerical rating scale and the Faces, Legs, Activity, Cry, and Consolability Scale were used for pain scoring.

Results

During the study period (01/2016–10/2016), 284 children (median age 10.7 years, interquartile range 6.7–14.8) were recruited. In a univariate analysis, older age, higher pre-procedure pain scores, longer procedure durations, higher number of biopsies and longer recovery duration were associated with higher post-procedure pain scores. In a multivariate analysis higher pain scores before the procedure (OR 12.42, 95% CI 3.67–42, P < 0.001) and older age (OR 1.016, 95% CI 1.007–1.025, P < 0.001) were associated with higher pain scores after the procedure. Children with a higher pain score before the procedure also had a longer recovery period (OR 5.28, 95% CI (1.93–14.49), P = 0.001).

Conclusion

Older age and higher pain score before the procedure were identified as predictors for higher pain score after pediatric gastrointestinal endoscopies. Children with these risk factors should be identified before the procedure in order to personalize their post-procedure management.
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Literature
1.
go back to reference Lee YC, Wang HP, Chiu HM, et al. Factors determining post-colonoscopy abdominal pain: prospective study of screening colonoscopy in 1000 subjects. J Gastroenterol Hepatol. 2006;21:1575–80.CrossRef Lee YC, Wang HP, Chiu HM, et al. Factors determining post-colonoscopy abdominal pain: prospective study of screening colonoscopy in 1000 subjects. J Gastroenterol Hepatol. 2006;21:1575–80.CrossRef
2.
go back to reference Huguet A, McGrath PJ, Pardos J. Development and preliminary testing of a scale to assess pain-related fear in children and adolescents. J Pain. 2011;12:840–8.CrossRef Huguet A, McGrath PJ, Pardos J. Development and preliminary testing of a scale to assess pain-related fear in children and adolescents. J Pain. 2011;12:840–8.CrossRef
3.
go back to reference von Baeyer CL, Spagrud LJ, McCormick JC, Choo E, Neville K, Connelly MA. Three new datasets supporting use of the numerical rating scale (NRS-11) for children’s self-reports of pain intensity. J Pain. 2009;143:223–7.CrossRef von Baeyer CL, Spagrud LJ, McCormick JC, Choo E, Neville K, Connelly MA. Three new datasets supporting use of the numerical rating scale (NRS-11) for children’s self-reports of pain intensity. J Pain. 2009;143:223–7.CrossRef
4.
go back to reference Castarlenas E, Jensen MP, von Baeyer CL, Miró J. Psychometric properties of the numerical rating scale to assess self-reported pain intensity in children and adolescents: a systematic review. Clin J Pain. 2017;33:376–83.CrossRef Castarlenas E, Jensen MP, von Baeyer CL, Miró J. Psychometric properties of the numerical rating scale to assess self-reported pain intensity in children and adolescents: a systematic review. Clin J Pain. 2017;33:376–83.CrossRef
5.
go back to reference Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23:293–7.PubMed Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23:293–7.PubMed
6.
go back to reference Kochman A, Howell J, Sheridan M, et al. Reliability of the faces, legs, activity, cry, and Consolability scale in assessing acute pain in the pediatric emergency department. Pediatr Emerg Care. 2017;33:14–7.CrossRef Kochman A, Howell J, Sheridan M, et al. Reliability of the faces, legs, activity, cry, and Consolability scale in assessing acute pain in the pediatric emergency department. Pediatr Emerg Care. 2017;33:14–7.CrossRef
7.
go back to reference Hirschfeld G, Zernikow B. Variability of "optimal" cut points for mild, moderate, and severe pain: neglected problems when comparing groups. Pain. 2013;154:154–9.CrossRef Hirschfeld G, Zernikow B. Variability of "optimal" cut points for mild, moderate, and severe pain: neglected problems when comparing groups. Pain. 2013;154:154–9.CrossRef
8.
go back to reference Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the face, legs, activity, cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain. 2015;156:2132–51.CrossRef Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the face, legs, activity, cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain. 2015;156:2132–51.CrossRef
9.
go back to reference Kristensen HN, Lundbye-Christensen S, Haslund-Thomsen H, Graven-Nielsen T, Elgaard SE. Acute procedural pain in children: intervention with the hospital clown: Clin J Pain; 2018. [Epub ahead of print] Kristensen HN, Lundbye-Christensen S, Haslund-Thomsen H, Graven-Nielsen T, Elgaard SE. Acute procedural pain in children: intervention with the hospital clown: Clin J Pain; 2018. [Epub ahead of print]
10.
go back to reference Khasar SG, McCarter G, Levine JD. Epinephrine produces a beta-adrenergic receptor-mediated mechanical hyperalgesia and in vitro sensitization of rat nociceptors. J Neurophysiol. 1999;81:1104–12.CrossRef Khasar SG, McCarter G, Levine JD. Epinephrine produces a beta-adrenergic receptor-mediated mechanical hyperalgesia and in vitro sensitization of rat nociceptors. J Neurophysiol. 1999;81:1104–12.CrossRef
11.
go back to reference Kokanali MK, Cavkaytar S, Guzel Aİ, et al. Impact of preprocedural anxiety levels on pain perception in patients undergoing office hysteroscopy. J Chin Med Assoc. 2014;77:477–81.CrossRef Kokanali MK, Cavkaytar S, Guzel Aİ, et al. Impact of preprocedural anxiety levels on pain perception in patients undergoing office hysteroscopy. J Chin Med Assoc. 2014;77:477–81.CrossRef
12.
go back to reference Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S. Preoperative anxiety and postoperative pain in patients undergoing septoplasty. B-ENT. 2015;11:19–23.PubMed Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S. Preoperative anxiety and postoperative pain in patients undergoing septoplasty. B-ENT. 2015;11:19–23.PubMed
13.
go back to reference Daoust R, Paquet J, Bailey B, et al. Vital signs are not associated with self-reported acute pain intensity in the emergency department. CJEM. 2016;18(1):19–27.CrossRef Daoust R, Paquet J, Bailey B, et al. Vital signs are not associated with self-reported acute pain intensity in the emergency department. CJEM. 2016;18(1):19–27.CrossRef
14.
go back to reference Block PR, Thorn BE, Kapoor S, et al. Pain Catastrophizing, rather than vital signs, associated with pain intensity in patients presenting to the emergency Department for Pain. Pain Manag Nurs. 2017;18(2):102–9.CrossRef Block PR, Thorn BE, Kapoor S, et al. Pain Catastrophizing, rather than vital signs, associated with pain intensity in patients presenting to the emergency Department for Pain. Pain Manag Nurs. 2017;18(2):102–9.CrossRef
15.
go back to reference Korterink J, Devanarayana NM, Rajindrajith S, et al. Childhood functional abdominal pain: mechanism and management. Nat Rev Gastroenterol Hepatol. 2015;12(3):159–71.CrossRef Korterink J, Devanarayana NM, Rajindrajith S, et al. Childhood functional abdominal pain: mechanism and management. Nat Rev Gastroenterol Hepatol. 2015;12(3):159–71.CrossRef
16.
go back to reference Allen P, Shaw E, Jong A, et al. Severity and duration of pain after colonoscopy and gastroscopy: a cohort study. J Clin Nurs. 2015;24:13–4.CrossRef Allen P, Shaw E, Jong A, et al. Severity and duration of pain after colonoscopy and gastroscopy: a cohort study. J Clin Nurs. 2015;24:13–4.CrossRef
17.
go back to reference Marseglia L, Manti S, D’angelo G, et al. Potential use of melatonin in procedural anxiety and pain in children undergoing blood withdrawal. J Biol Regul Homeost Agents. 2015;29:509–14.PubMed Marseglia L, Manti S, D’angelo G, et al. Potential use of melatonin in procedural anxiety and pain in children undergoing blood withdrawal. J Biol Regul Homeost Agents. 2015;29:509–14.PubMed
18.
go back to reference Gold J, Mahrer NE. Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. J Pediatr Psychol. 2018;43:266–75.CrossRef Gold J, Mahrer NE. Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. J Pediatr Psychol. 2018;43:266–75.CrossRef
19.
go back to reference Sabzevari A, Kianifar H, Jafari SA, et al. The effect of music on pain and vital signs of children before and after endoscopy. Electron Physician. 2017;9:4801–5.CrossRef Sabzevari A, Kianifar H, Jafari SA, et al. The effect of music on pain and vital signs of children before and after endoscopy. Electron Physician. 2017;9:4801–5.CrossRef
20.
go back to reference Feisthammel J, Vu Trung K, Hollenbach M, et al. Is CO2 insufflation an amelioration of routine colonoscopy? Minerva Gastroenterol Dietol. 2018;64(3):193–200.CrossRef Feisthammel J, Vu Trung K, Hollenbach M, et al. Is CO2 insufflation an amelioration of routine colonoscopy? Minerva Gastroenterol Dietol. 2018;64(3):193–200.CrossRef
Metadata
Title
Age and pain score before gastrointestinal endoscopies in children are predictors for post procedure pain
Authors
Tut Galai
Anat Yerushalmy-Feler
Nathan P. Heller
Amir Ben-Tov
Yael Weintraub
Achiya Amir
Hadar Moran-Lev
Lilach Zac
Shlomi Cohen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2020
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-020-01546-y

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