From The New York Daily News
October 19, 1998
New methods help doctors ease trauma before it hurts
KIDS & pain
By Susan Ferraro
In the memoir "Boy," Roald Dahl wrote of how, when he was very small, his tonsils were pinched out, in the doctor's office, without benefit of any anesthetic. And this reporter's own mother never forgot the horrifying pain she endured in childhood when a doctor lanced her middle ear - also without anesthetic.
Pain hurts more when you are small, doctors say. Trauma triggered by the sting of a needle or a cut being sewn up without anesthetic can make kids distrustful of both parents and doctors, and even set up a lifelong aversion to medical procedures.
Though doctors are learning more about kid-size pain, a booster shot or vaccination can still turn routine visits to the pediatrician into full-scale battles. But now, coming to the rescue, there are new methods to prevent even routine pain in advance, and scientists are working on others.
- A numbing cream called EMLA, made of lidocaine and prilocaine, is available in a "peel and stick" topical form. It can be used for kids more than a month old to dull the pain of needle sticks. Available by prescription, it is applied at home in advance of an office visit.
- More pediatric surgeons are using pain medication to cease discomfort before and after kids' surgery - a big step, as for years the official attitude was that giving heavy-duty painkillers to small people was neither safe or sound medical practice.
- Patches of tiny "microneedles" may one day deliver insulin and some forms of chemotherapy painlessly, say researchers who are developing them at Georgia Tech. They could especially benefit kids and diabetics who need frequent injections, according to Mark Prausnitz, one of the inventors.
The silicon patches - hundreds of small needles just 10 to 20 mlerons long (about 1/50th of a millimeter) and too short to reach nerve endings - would deliver medication subcutaneously, just under the very top layers of skin.
Big scary hypodermics won't disappear - they are still necessary for medicine that goes directly into muscle or blood. But respecting kids' pain, and preparing for it, are key steps in alleviating anxiety, say experts. In the pediatric office, parents are their children's advocates.
- Newborn needle sticks - blood taken from babies' heels to test liver function - may soon be a thing of the past. A study of 2,441 infants led by pediatricians at Mount Sinai Medical Center showed that a no-needle, non-invasive color monitor for assessing skin tone accurately identifies those babies developing bilirubin jaundice.
It can also monitor them during treatment. The device is called Colormate TLc-BiliTest, is FDA-approved and is sure to bring comfort to babies - and their frantic parents, who until now, have had to stand by helplessly as their babies were poked. |
