VCUG and the recurring question of sedation: preparation and catheterization technique are key
2012
Estimated 50,000 children are diagnosed with VUR after UTI each year in the United States; thus “the number of children undergoing screening examinations (VCUGs), therefore, is likely in the many hundreds of thousands.”
“The vast majority of VCUG examinations are performed primarily on an outpatient basis, unfortunately often with little or no preparation of the child or parent. The VCUG examination can therefore be perceived as a painful investigation associated with high levels of distress and anxietyfor the child, parents, and even the medical staff.”
“Unfortunately, many children have been irreparably traumatized by previous catheterizations as well as other invasive medical procedures and the mere thought of undergoing an unknown or repeat procedure is unbearable.”
“…any radiologist who performs VCUG examinations has on occasion walked into the fluoroscopy suite only to find a shocked, distraught, or even angry parent who had no idea that their child was to undergo this type of examination. The test is either canceled…. Or the examination proceeds in an uncomfortable environment, more often than not resulting in a traumatic experience for the child and parent.”
The article goes on to mention several ways that the VCUG can be improved including preparation of parent and child with thorough explanations of the examination, use of lidocaine before catheterization, distraction techniques, and sedation.
The article then says, disrespectfully to former VCUG patients, “If the argument is that sedation is primarily needed to prevent the stress and anxiety associated with invasive medical procedures in children, then how can we justify not routinely sedating for immunizations, blood draws, nasoenteric tube placement, lumbar punctures, etc. These procedures surely are equally as distressing to children.”
NOTE: These procedures are not equally as distressing; this is a baseless claim without any research to support it.)