Pain control during diagnostic and/or therapeutic procedures in children

Children's fear of pain in illness has been greatly underestimated. In cancer disease, pain characterizes most of the diagnostic and long-term therapeutic procedures. Children's psycho-emotional processing during illness has been recently recognized as characterized by loss of control, anger, and fear, to which pain adds fear of death jeopardizing the sense of survival. Illness and pain provoke a traumatic condition affecting psychoemotional maturation. The aim of the pharmacologic and psychologic support is to help children better cope with pain and prevent the healed child having traumatic effects in his/her future personality structure and behavior. To assure the best pain control, support has to be offered right from the first intrusive procedure in order to avoid anticipatory anxiety. Respiration, relaxation, visualization, desensibilization through the "switch technique" and the "magic glove", distraction and involvement, muscular relaxation all have the common aim of focusing the child's mind and attention away from body perception of pain connected to the procedure. Different medical methods are utilized depending on the child's age and the level of consciousness required for the procedure. Local anaesthesia and conscious sedation are used. Children are particularly sensitive in this critical condition and need as serene and comfortable an environment as possible. Relief of pain and suffering in cancer treatments that cause further discomfort to the patient is a fundamental ethics in the treatment of clinical neoplasias.