ID #679 Effect of Topical Dicain Gel Combined with Psychological Intervention on Pain and Fear Reduction During Lumbar Puncture in Pediatric Neuro-Oncology Patients: A Prospective Before-After Study
Shaoqun Li, Mingyao Lai, Fuqiang Zhang, Xing Zhang, Lijun Huang, Lian Chen, Linbo CaiAbstract
Purpose
To evaluate whether adding topical dicain gel and psychological intervention to lidocaine local infiltration anesthesia reduces pain and medical fear during lumbar puncture in pediatric neuro-oncology patients.
Methods
A prospective, single-center before-after study conducted at Guangdong Sanjiu Brain Hospital from October 2024 to December 2025. Children undergoing lumbar puncture under lidocaine local infiltration anesthesia received topical dicain gel and psychological intervention. Pre- and post-puncture scores for medical fear and pain were collected. Wilcoxon signed-rank tests were used for statistical analysis. All participants were accompanied by a family member and a psychologist during the puncture.
Results
Sixteen pediatric neuro-oncology patients were enrolled (male:female, 3:1), with a median age of 9 years. Pain scores decreased from a pre-procedure expectation median of 6 to an actual post-intervention median of 4 (p = 0.02). The overall fear score declined from a median of 17.5 to 13.5 after the intervention (p = 0.001). Within the fear domains, improvements were observed in: posture (p = 0.008), puncture site localization (p = 0.02), puncture (p = 0.002), absence of family (p = 0.007), and pain fear (p = 0.005). Throughout all procedures, all children were accompanied by a family member and a psychologist. Children tended to rely more on family than on the psychologist during invasive procedures.
Conclusions
In children undergoing lumbar puncture, adding topical dicain gel to lidocaine local infiltration anesthesia along with psychological intervention significantly reduces pain and medical fear. Family presence during invasive procedures appears beneficial for pediatric cooperation and comfort. Limitations include the small sample size, single-center design, and lack of randomization; results require validation in larger randomized controlled trials to delineate the contributions of each intervention component and assess long-term outcomes.