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Intra-articular corticosteroid injection (IASI), a common procedure in juvenile idiopathic arthritis (JIA), is usually associated with anxiety and pain.  In previous study we concluded that nitrous oxide (NO) provides effective and safe sedation for such procedures. The efficacy in reducing pain was associated with the level of the child's anxiety even before starting the procedure.  Following the introduction of "Dream Doctors" in our hospital, we added medical clown as an important integral part of the team doing IASI.

pediatric rheumatology online journal

PReS-FINAL-2117: Dream doctors - medical clowns increase the effect of nitrous oxide sedation in intra-articular corticosteroid injection for juvenile idiopathic arthritis