PAIN DURING LUMBAR PUNCTURE - A 2-YEAR DI SCUSSION AT THE SOCIETE-FRANCAISE-DONCOLOGIE-PEDIATRIQUE

Background. - Lumbar puncture is a common procedure in pediatric onco- hematology. Repeated invasive painful procedures may contribute to inc rease distress displayed during medical treatment, and cause regressio n, depression and other psychological disorders. Material and methods. - A two-year workshop of the Societe' francaise d'oncologie pediatriq ue was reviewed through a questionnaire assessing changes in technical management of lumbar puncture, local anesthesia, sedation and cogniti ve-behavioral interventions. Results. - Significant changes were found for pain assessment, local anesthesia procedures, and nitrous oxide a dministration. The extensive use of the Emla(R) cream largely contribu ted to reduce pain. Anxiety however remained an unsolved problem, part icularly among young children. Conclusion. - Pain in pediatrics remain s a major challenge. This workshop is a model of reflexion to achieve a better management of pain during invasive medical procedures.