Prescription and administration of around the clock analgesics in postoperative pediatric cardiovascular surgery patients.

Despite an increased awareness of postoperative pain management in infants and children, they are still often undermedicated. The importance of providing maximum comfort to children following cardiac surgery is accentuated with shortened hospital stays that require early ambulation to achieve early discharge. The purposes of this study were to evaluate the administration of prescribed around the clock (ATC) pain medication and documentation of pain assessment when administering pro re nata (prn) analgesics. A descriptive design was used to study 114 consecutive patients who underwent surgery for congenital heart disease. Administration of ordered ATC medications was best in the sternotomyl > 24 months of age group and poorest in the thoracotomyl < 24 months of age group. The use of the Wong-Baker FACES Pain Rating Scale in patients who were > 36 months of age (n = 71) was 38% for predose evaluation and only 15% for postdose evaluation. Findings suggest that the postoperative pain of infants and young children demands better attention. The administration of prescribed ATC medications is imperative in providing maximal postoperative pain relief in the pediatric cardiovascular surgery patient.