Which factors affect how a child responds to a painful procedure?

Updated: May 08, 2018
  • Author: Wan-Tsu Wendy Chang, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Various individual internal and external factors determine how a child responds to painful procedures and thus affect the decision whether to premedicate the child. Individualized dosing and titratable agents are often necessary.

Internal factors include the child’s age, developmental level, and previous experience. Some children have previously had unpleasant experiences at the hospital and are difficult to manage long before any noxious stimuli occur. These children typically require sedation even when other patients who are the same age may not.

External factors have as much, if not more, influence on a child’s behavior. These include parental interactions with the child, preparation for the procedure, the clinician’s skill, and the physical setting where the procedure is performed. Spending a few minutes preparing the anxious child for a procedure is always in the practitioner’s best interest. Attempting to build trust and being honest about what will and will not hurt may go a long way toward ensuring cooperation.

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