Pharmacobehavioral Intervention: Integrating Pharmacologic and Behavioral Techniques for Pediatric Medical Procedures

Despite an increasing awareness of the problem of pediatric acute pain, many children continue to suffer pain and anxiety associated with medical procedures. Traditionally intervention for medical procedures has focused on either behavioral or pharmacology techniques. However, nonpharmacologic techniques can be an important adjunct to pharmacologic methods of reducing or preventing pain and distress associated with medical procedures. Although in many pediatric settings these techniques are combined, there is little discussion in the pediatric literature regarding how to practically implement such an integrated approach. The purpose of this article is to describe an integrated treatment approach that can be routinely implemented by health care providers, such as nurses, physicians, and technicians, when performing medical procedures in the pediatric setting. Specifically, the advantages and disadvantages of behavioral and pharmacologic techniques are described, as well as how they can be integrated throughout four phases of a medical procedure: (a) anticipation, (b) preparation, (c) procedure, and (d) recovery.