The Effect of Injectable Medication Procedure on the Level of Pain among Early Childhood patients

Abstract views: 1348 / PDF downloads: 1008


  • Farida A. K. Tahir Department of Midwifery, Sulaimani Technical Institute, Sulaimani Polytechnic University, Sulaimani, Iraq
  • Pary M. Azize Nursing department, College of Health, Sulaimani Polytechnic University, Sulaimani, Iraq
  • Aram N. Abdul Razzaq School of Nursing, University of Sulaimani, Sulaimani, Iraq


Abstract Children are often exposed to painful procedures during hospitalization. Validated age appropriate scales are available to assess pain among pediatric patients. The aim of this study is to find out the effect of injectable medication procedure on the level of pain among early childhood patients. This descriptive cross -sectional study was designed to assess the physiological and behavioral characteristic of pain using CRIES pain rating scale for both medical and surgical conditions, which contains (cry, spo2, heart rate, facial expression and sleep pattern). The study has been conducted for twelve weeks duration in the pediatric wards at medical and surgical hospitals in the Sulaimani city – Kurdistan region of Iraq between 1st March to 1st Jun 2019. Fifty early childhood aged between (1 month- 3years) were participated and assessed pre injectable medication procedure and after. CRIES pain scales were applied to the children and show that there are highly significant differences between pain and the physiological, behavior characteristics between pre and after the procedure in the p-value < .00001 such as crying was developed from high pitch crying to inconsolable in post-procedure. Consumption of O2 also increased. In terms of heart rate was increased up to 20% than baseline, while, in the post-procedure, the change was more than 20% of the baseline. Facial expression was also changed to contracted face in the post procedure. Sleeping from short interval to absent sleeping was shown. Significant variation between pre and post-procedure were assessed. Further variation between medical and surgical condition for mean score of every scale of CRIES were assessed. The implications of this study will impact on health professional’s education; practice and future research are also recommending.


pain, CRIES, pain rating tools, consequence of pain. Physiological sign, behavioral sign


[1]. K. Hanoch Kumar, P. Elavarasi. " Definition of pain and classification of pain disorders". Journal of Advanced Clinical & Research Insights 3, 87-90. 2016.
[2]. Y Jarred , M Rebecca , M Sean, "Pain Outcomes: A Brief Review of Instruments and Techniques". Current Pain and Headache Reports. 13(1): 39-43. 2009.
[3]. H Ivan. , N Lawrence , G Donna , W Laura , H , "COVERS Neonatal Pain Scale: Development and Validation". International Journal of Pediatrics 496719. 1-5. 2010.
[4]. B Kathryn , T Chambers. F Conrad. F Paula, L Margot. M Patrick et al., "Hospitalized children continue to report undertreated and preventable pain". Pain Research & Management. 19(4): 198-204, 2014.
[5]. W Nancy; P; Chris M.McCaffery, "Improving the Quality of Care Through Pain Assessment and Management". Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Agency for Healthcare Research and Quality (US); April.2008.
[6]. D María , O Begoña , S Alejandro, M A Juan , and F Inmaculada . "A review of chronic pain impact on patients, their social environment and the health care system" Journal of Pain Research. 9: 457-467, 2016.
[7]. H Linda.and E Elizabeth. "Measurement of Acute Pain in Infants:A Review of Behavioral and Physiological Variables". Biological Research for Nursing. 17(1) 100-111. 2015.
[8]. S. W. Krechel and J. Bildner, "CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability," Paediatric Anaesthesia, vol. 5, no. 1, pp. 53-61, 1995.
[9]. S Rasha , R Savithiri , S Suzan "Pain in Children: Assessment and Nonpharmacological Management. International Journal of Pediatrics, 474838, 1- 11 2010.
[10]. B Alexandra i, M Kolia; P Dominique. "Pain Assessment in Newborns, Infants, and Children". Pediatric Annals. 46(10): e387- e395. 2017.
[11]. M D Gleicia, PL Ana L de Aguiar, F Alline, M de Moura, M Vera Lúcia C Leitão . D MViviane. "Pain assessment scales in newborns: integrative review". Revista Paulista de Pediatria. 32(4), 2014.
[12]. YK Chunawalla, MR Bohari, MN Bijle. "Correlation of Crying Pattern to Clinical Diagnosis of Children undergoing treatment". International Journal of Contemporary Dentistry; 1:73-76. 2010
[13]. L. S Cook,"Needle phobia". Journal of Infusion Nursing 39(5): 273-279. 2016.
[14]. DJ Elias . "Does Pain Lead to Tachycardia? Revisiting the Association Between Self-reported Pain and Heart Rate in a National Sample of Urgent Emergency Department Visits", Mayo Clinic Proceedings. 90(8): 1165-1166. 2016.
[15]. J Chang , J Versloot , SR Fashler , KN McCrystal , KD Craig ."Pain assessment in children: validity of facial expression items in observational pain scales". The Clinical Journal of Pain. 31(3):189-97. 2015.
[16]. C. Darwin The expression of emotion in man and animals. New York: Philosophical library; 1872/1955.
[17]. National sleep foundation. " sleep & disease, sleep & lifestyles: sleep and pain" . 2019.
[18]. F H Patrick , G R Burel and ST Michael. "The association of sleep and pain: An update and a path forward". The Journal of Pain. 14(12): 1539-1552. 2013.
[19]. EJ Stepanski, MS Walker, LS Schwartzberg, LJ Blakely, JC Ong, AC. Houts "The relation of trouble sleeping, depressed mood, pain, and fatigue in patients with cancer". Journal of clinical sleep medicine:: official publication of the American Academy of Sleep Medicine. 5:132, 2009.


How to Cite

F. A. K. Tahir, P. M. Azize, and A. N. Abdul Razzaq, “The Effect of Injectable Medication Procedure on the Level of Pain among Early Childhood patients”, KJAR, pp. 29–36, Aug. 2019, doi: 10.24017/science.2019.ICHMS.3.

Article Metrics





Pure and Applied Science