This article is more than 5 years old. Information may no longer be current.
Methotrexate injections linked to mild pain in children with rheumatic diseases
Click Here to Manage Email Alerts
Children with rheumatic diseases were shown to experience mild pain with subcutaneous injections of methotrexate, although the adverse events may increase the amount of perceived pain, according to recently published research.
The researchers studied 27 patients aged 4 years to 7 years who received weekly subcutaneous treatments of methotrexate for mean duration of 2.5 years. Most patients (73%) were diagnosed with juvenile idiopathic arthritis and were receiving treatment for at least 4 weeks.
All but one of the patients were given 25 mg/mL methotrexate injections. The majority of patients (82.9%) had no active joints at the time of the survey.
Participants were trained to use the Faces Pain Scale – Revised (FPS-R) and Faces, Legs, Arms, Cry, Consolability tools to rate pain associated with injections. Higher intensity of pain was seen by patients in whom adverse events were present, but intensity was unaffected by duration of treatment or age. About 61% reported no to mild pain and 31% of the patients reported moderate pain. Two patients reported severe pain, one of whom used an alternate delivery system and was excluded from further analysis. Most participants (61%) experienced an adverse event, such as nausea or vomiting, and reported more pain intensity. Anticipatory nausea was reported by 56% of patients who experienced nausea.
The use of ice on the injection site, comfort positions such as hugging, rewards, reassurances and distractions were among strategies used by caregivers to alleviate pain perception. Most patients reported the method used was somewhat effective.
Disclosure: The authors have no relevant financial disclosures.
Click Here to Manage Email Alerts