Cannula Type and Pain Response in Pediatric Rectal Suspension: A Prospective Study

Background:Functional constipation is a prevalent condition in children, often requiring rectal suspension as part of its management. While various cannula types are available for this procedure, their impact on pain perception remains understudied.Methods:This prospective observational study was conducted in the pediatric emergency unit of a central city hospital in Turkey. Children aged 1-3 years, diagnosed only with functional constipation, treated with sorbitol + glycerin (SG) or monobasic sodium phosphate dehydrate + dibasic sodium phosphate dodecahydrate (MD), who had not completed toilet training and had no chronic illness, were included in the study (n = 156). In the study, data were collected using the "patient information form" and "face, legs, activity, cry, and consolability (FLACC) behavioral scale."Results:Of the children, 61.9% had experienced constipation 2-3 times before. During the procedure, the mean FLACC score was 8.09 +/- 1.49 in the SG applicator group and 4.75 +/- 1.75 in the SG catheter group (P <= 0.001); it was 8.72 +/- 1.57 in the MD applicator group and 5.09 +/- 1.54 in the MD catheter group (P <= 0.001). In both types of rectal suspensions, during the procedure the mean HR in the applicator group was higher (P <= 0.001), and the mean SpO(2) was lower compared to the catheter group (P <= 0.001).Conclusion:Rectal suspension administration causes pain in children with functional constipation. Children experienced moderate pain with rectal suspension administered via catheter and above-average pain with rectal suspension administered via applicator. Using a catheter instead of an applicator for rectal suspension is a more clinically appropriate option.