Up until approximately three decades ago, little emphasis was placed on alleviating pain and anxiety during medical procedures. Children who were anxious or subjected to a painful procedure were often physically restrained when deemed uncooperative, leading to emotional distress during and beyond the medical encounter.

It is now established that when procedural pain and anxiety are not carefully managed, children can suffer far-reaching emotional distress, even leading to Pediatric Medical Traumatic Stress (PMTS). PMTS refers to mental and physical reactions to a medical procedure, illness or injury, including reexperiencing, avoidance, and arousal, which can deeply impact children and their families, similar to post traumatic stress disorder.

With the publication of paradigm-shifting studies starting with the proven ability of children as young as premature infants to remember pain, the field of Procedural Sedation and Analgesia (PSA) has however significantly moved forward, and multiple pharmacological and nonpharmacological techniques to diminish procedural distress have since been developed, investigated and implemented.

Nonpharmacological techniques, such as distraction, play, desensitization and habituation, technological tools and hypnosis have shown their efficacy and are now considered essential and a constitutive part to PSA. Pharmacological sedation, when needed, has also proven to be safe and effective when used by trained providers.

In this Privat Docent thesis, I have tried to illustrate my contribution to procedural comfort, through several articles I authored. After providing background context, the publications are presented in a consecutive manner, followed by a careful discussion on potential future research perspectives.