title: Review of systematic reviews on acute procedural pain in children in the hospital setting.
abstract: BACKGROUND
  Acute pain is a common experience for hospitalized children. Despite mounting research on treatments for acute procedure-related pain, it remains inadequately treated.
  
  
  OBJECTIVE
  To critically appraise all systematic reviews on the effectiveness of acute procedure-related pain management in hospitalized children.
  
  
  METHODS
  Published systematic reviews and meta-analyses on pharmacological and nonpharmacological management of acute procedure-related pain in hospitalized children aged one to 18 years were evaluated. Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Two reviewers independently selected articles for review and assessed their quality using a validated seven-point quality assessment measure. Any disagreements were resolved by a third reviewer.
  
  
  RESULTS
  Of 1469 published articles on interventions for acute pain in hospitalized children, eight systematic reviews met the inclusion criteria and were included in the analysis. However, only five of these reviews were of high quality. Critical appraisal of pharmacological pain interventions indicated that amethocaine was superior to EMLA (AstraZeneca Canada Inc) for reducing needle pain. Distraction and hypnosis were nonpharmacological interventions effective for management of acute procedure-related pain in hospitalized children.
  
  
  CONCLUSIONS
  There is growing evidence of rigorous evaluations of both pharmacological and nonpharmacological strategies for acute procedure-related pain in children; however, the evidence underlying some commonly used strategies is limited. The present review will enable the creation of a future research plan to facilitate clinical decision making and to develop clinical policy for managing acute procedure-related pain in children.
authors.affiliation: Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Centre for Nursing and Department of Anesthesia, The Hospital for Sick Children, Toronto, Ontario. jennifer.stinson@sickkids.ca
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stinson
authors.forename: Janet
authors.initials: J
authors.lastname: Yamada
authors.forename: Alison
authors.initials: A
authors.lastname: Dickson
authors.forename: Jasmine
authors.initials: J
authors.lastname: Lamba
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
mesh_terms: D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D003955:Diagnostic Tests, Routine / Q000009:adverse effects*; D006801:Humans; D010146:Pain / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control*; D000078202:Systematic Reviews as Topic