Pain and stress in pediatric uro-radiology: efficacy of a specific protocol

Two hundred and seven children undergoing either intravenous pyelography (IVP) or voiding cysto-urethrography (VCUG) were examined. Under the age of 5 years, children received intra-rectal midazolam (0.5 mg/kg) with a maximum of 5 mg. Children over 5 years, self-inhaled an equimolar mixture of oxygen and nitrous oxide. Pain and stress were evaluated in children under 5, by the pediatric radiologist according to the 4 non verbal items of the Le Baron-Zeltzer scale and in children over 5 by the child himself with a visual analogic scale. Under 5 years of age, midazolam significantly reduced pain and stress during IVP (p <0.0001), VCUG both in boys (p <0.0001) and girls (p <0,0001). In children over 5, nitrous oxide inhalation reduced pain during IVP (p = 0.0004), during VCUG in girls (p = 0,0025), but not in boys ((p >0.05). Pediatric radiologists should evaluate pain and stress in their patients as they can be easily and safely limited. (authors)