Survivors of childhood cancer describe vivid memories of their experience with repeated painful procedures during treatment. These procedures include needle puncture for IM chemotherapy (I.-asparaginase ),IV lines, port access and blood draws ,lumbar puncture, bone marrow aspiration and biopsy, removal of central venous catheters, and other invasive diagnostic procedures. Fear and anxiety related to these procedures may be minimize with parent and child preparation. The preparation starts with obtaining information from the parent about the child's coping styles, explaining the procedure and enlisting their support, followed by an age-appropriate explanation to the child. Topical analgesics (cold sprays, EMLA amethocaine gels ) , as discussed previously, are effective in providing analgesia before needle procedures