ABSTRACT
The anatomic and physiologic capacities to respond to nociception develop early in fetal life and acute behavioral and biochemical responses to tissue damage are well documented in preterm and full-term neonates. Moreover, a child’s first experience with unrelieved pain will affect how it reacts to subsequent painful events: for example, A. Taddio et al. noted that neonates circumcised without anesthesia show an increased behavioral response to routine vaccination at four or six months of age when compared with neonates circumcised with local anesthesia. Last, children often learn by associating neutral with nonneutral stimuli: a neutral event like visiting a doctor can thus easily be associated with a nonneutral stimulus such as pain, fear, and anxiety if the visit includes a painful procedure. A first bad medical experience can thus influence a child’s attitude toward medicine for a long time. Midazolam, a short-acting benzodiazepine, is a convenient sedative for procedures in children.
