Sepponen K, Kokki H, Ahonen R
Department of Social Pharmacy, University of Kuopio, Finland.
Pharm World Sci. 1999 Aug;21(4):168-72. doi: 10.1023/a:1008793223756.
The aim of this study was to describe how parents manage their child's postoperative pain at home following day-case surgery. The incidence of pain, different analgesics used and problems related to administering medications were the main interests of the study. A postal questionnaire was sent to the parents of 275 children who were under 8 years of age and had undergone an ear, nose and throat (ENT) day-case operation. The questionnaire was sent to the parents a week after discharge from hospital. Altogether, the parents of 227 children answered the questionnaire (response rate 83%). The study was divided into two phases (preintervention and postintervention), and incorporated a training program for doctors and nurses between these two phases. The training program aimed to improve the treatment practices of postoperative pain in children. Seventy-eight per cent of the children in the preintervention study and 75% in the postintervention study experienced at least mild pain after discharge. The training program for doctors and nurses affected the home treatment practices of postoperative pain. The proportion of parents treating their children increased from 68% to 80% after the training program (p = 0.028). Many parents faced problems while treating their children; for example, 19% (n = 30) of the children refused to take their medicine, and suppositories were regarded to be an especially unpleasant dosage form. However, no serious adverse effects were reported. We conclude that due to the pain experienced at home by the great majority of children following day-case ENT operations, parents need information on how to manage their child's pain. A training program for doctors and nurses can improve the treatment of children's pain even at home. Since some children dislike suppositories, it would be worth considering the use of small tablets or mixtures instead.
本研究的目的是描述家长如何在家中管理日间手术患儿术后的疼痛。疼痛发生率、使用的不同镇痛药以及给药相关问题是本研究的主要关注点。向275名8岁以下接受耳鼻喉科日间手术的儿童家长邮寄了问卷。问卷在患儿出院一周后寄给家长。共有227名儿童的家长回复了问卷（回复率83%）。该研究分为两个阶段（干预前和干预后），并在这两个阶段之间为医生和护士开展了一个培训项目。该培训项目旨在改善儿童术后疼痛的治疗方法。干预前研究中78%的儿童和干预后研究中75%的儿童在出院后至少经历了轻度疼痛。医生和护士的培训项目影响了术后疼痛的家庭治疗方法。培训项目后，治疗孩子的家长比例从68%增加到了80%（p = 0.028）。许多家长在治疗孩子时面临问题；例如，19%（n = 30）的儿童拒绝服药，栓剂被认为是一种特别令人不适的剂型。然而，未报告严重不良反应。我们得出结论，由于绝大多数耳鼻喉科日间手术患儿在家中会经历疼痛，家长需要了解如何管理孩子的疼痛。为医生和护士开展的培训项目即使在家庭环境中也能改善儿童疼痛的治疗。由于一些儿童不喜欢栓剂，考虑使用小片剂或合剂替代可能是值得的。
