Charles Lamy1, Valérie Loizeau2, Catherine Couquet3, Caroline Sturtzer4, Coralie Fluteau5, Manon Dugas6, Anaïs Labrunie7, Benoît Marin8, Jean-Luc Desfougères9, Claire Bahans10, Vincent Guigonis11, Pascale Beloni12. 1. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: charlesophie.lamy@hotmail.fr. 2. CHI de Poissy, Département de pédiatrie, 11 rue du champs de Gaillards 78300 Poissy-St Germain-en-Laye, France. Electronic address: valerie.loizeau@chi-poissy.fr. 3. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: catherine.couquet@chu-limges.fr. 4. CHI de Poissy, Département de pédiatrie, 11 rue du champs de Gaillards 78300 Poissy-St Germain-en-Laye, France. Electronic address: caroline.sturtzer@chi-poissy.fr. 5. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: Coralie.fluteau@chu-limoges.fr. 6. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: manon_mear@hotmail.fr. 7. CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: anais.labrunie@chu-limoges.fr. 8. CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: benoit.marin@unilim.fr. 9. CHU de Limoges, Hôpital Dupuytren, CEBIMER, 2 avenue Martin Luther-King, 87042 LIMOGES cedex, France. Electronic address: jean-luc.desfougeres@chu-limoges.fr. 10. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: Claire.bahans@chu-limoges.fr. 11. CHU de Limoges, Hôpital de la mère et de l'enfant, Département de pédiatrie, 8 Avenue Dominique Larrey 87000 Limoges, France. Electronic address: vincent.guigonis@unilim.fr. 12. CHU de Limoges, Hôpital Dupuytren, Coordination Générale des Soins, 2 avenue Martin Luther-King, 87042 LIMOGES Cedex, France. Electronic address: pascale.beloni@chu-limoges.fr.
Abstract
BACKGROUND: In pre-continent children, collection bags are frequently used as a first-line option to obtain a urine specimen. This practice, acknowledged by several guidelines for the step of UTI screening, is driven by a perception of the technique as being more convenient and less painful. However, our own experience led us to consider bag removal as a painful experience. OBJECTIVE: Our aim was to determine whether the use of an oleo-calcareous liniment to aid bag removal reduced the acute pain expressed by young children. METHODS: This prospective, randomized, controlled, single blind study was carried out in two emergency pediatrics departments. Pre-continent children aged 0-36 months admitted with an indication for urine testing were eligible for the study. Urine for dipstick test screening was obtained using a collection bag. At micturition, the patients were randomized into bag removal with (intervention group) or without (control group) liniment. Bag removal was recorded on video in such a manner as to permit independent assessments of pain by two evaluators blinded to group allocation. Pain was assessed using the FLACC scale. FINDINGS:135 patients were analyzed: 70 in the intervention group and 65 in the control group. The median FLACC scores [interquartile range] for the intervention and control groups, respectively 4.0 [2.0-7.0] and 4.0 [3.0-7.0], did not differ significantly (p = 0.5). A FLACC score ≥4 was obtained for 56% of the patients and a score ≥7 for 28%. CONCLUSION: Removal of urine collection bags caused moderate to severe pain in half of the children included. The use of an oleo-calcareous liniment did not reduce this induced pain.
RCT Entities:
BACKGROUND: In pre-continent children, collection bags are frequently used as a first-line option to obtain a urine specimen. This practice, acknowledged by several guidelines for the step of UTI screening, is driven by a perception of the technique as being more convenient and less painful. However, our own experience led us to consider bag removal as a painful experience. OBJECTIVE: Our aim was to determine whether the use of an oleo-calcareous liniment to aid bag removal reduced the acute pain expressed by young children. METHODS: This prospective, randomized, controlled, single blind study was carried out in two emergency pediatrics departments. Pre-continent children aged 0-36 months admitted with an indication for urine testing were eligible for the study. Urine for dipstick test screening was obtained using a collection bag. At micturition, the patients were randomized into bag removal with (intervention group) or without (control group) liniment. Bag removal was recorded on video in such a manner as to permit independent assessments of pain by two evaluators blinded to group allocation. Pain was assessed using the FLACC scale. FINDINGS: 135 patients were analyzed: 70 in the intervention group and 65 in the control group. The median FLACC scores [interquartile range] for the intervention and control groups, respectively 4.0 [2.0-7.0] and 4.0 [3.0-7.0], did not differ significantly (p = 0.5). A FLACC score ≥4 was obtained for 56% of the patients and a score ≥7 for 28%. CONCLUSION: Removal of urine collection bags caused moderate to severe pain in half of the children included. The use of an oleo-calcareous liniment did not reduce this induced pain.