Baños JE, Barajas C, Martín ML, Hansen E, Cos MÁ, Bosch F, Martín R, Marco J, Dierssen T
Department de Farmacologia i de Terapèutica, Universitat Autònoma de Barcelona, Spain
Eur J Pain. 1999 Jun;3(3):275-282. doi: 10.1053/eujp.1999.0130.
There is a lack of information concerning the characteristics of pediatric postoperative pain in Southern European countries. The aim of this study was to document how postoperative pain in children was managed routinely at Spanish surgical wards.The study was carried out in three hospitals on the first postoperative day. Children were divided in four groups according to their age (years): Group I (3-5), II (6-8), III (9-11) and IV (12-14). The parameters evaluated were: analgesia characteristics (type of prescription, drug used and route of administration, prescribed dose and whether the drug was or was not administered, need of non-prescribed analgesics) and the postoperative pain intensity. The results were analysed using descriptive statistics. U-Mann Whitney, chi(2), ANOVA, Kruskall-Wallis and Student's t -test were also used.A total of 348 children ranging from 3 to 14 years were studied. The average age (+/- SD) was 8.2 +/- 3.3 and the majority were male (74%). Urologic surgery was the most frequent type of operation, with age (p<0.05) and hospital differences (p<0.001). The majority of the patients (52%) were prescribed an analgesic, but only 26% of them had an analgesia order at fixed dosage intervals. Differences among the hospitals were observed (p<0.001). The most commonly used analgesics were metamizol, propyphenazone, paracetamol and codeine. Differences in choice of drug in relation to age and hospital were significant (p< 0.001). Rectal was the preferred route of drug administration. Patient's age was unrelated with the prescribed analgesic dose. An average of 68% of prescriptions were given and half of the patients without scheduled analgesia needed to have analgesics administered. Around 20% of patients had high pain scores.Few paediatric patients are given analgesics at fixed dose intervals to treat postoperative pain. Pain relief therapy for children differs notably to that of adults, in respect to the drugs prescribed and the administered route. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.
在南欧国家，有关小儿术后疼痛特征的信息匮乏。本研究旨在记录西班牙外科病房对儿童术后疼痛的常规处理方式。
该研究在术后第一天于三家医院开展。根据年龄（岁）将儿童分为四组：第一组（3 - 5岁）、第二组（6 - 8岁）、第三组（9 - 11岁）和第四组（12 - 14岁）。评估的参数包括：镇痛特征（处方类型、所用药物及给药途径、规定剂量以及药物是否已给药、非处方镇痛药的需求）和术后疼痛强度。结果采用描述性统计进行分析。还使用了U - 曼 - 惠特尼检验、卡方检验、方差分析、克鲁斯卡尔 - 沃利斯检验和学生t检验。
共研究了348名年龄在3至14岁的儿童。平均年龄（±标准差）为8.2 ± 3.3岁，大多数为男性（74%）。泌尿外科手术是最常见的手术类型，存在年龄差异（p < 0.05）和医院差异（p < 0.001）。大多数患者（52%）被开了镇痛药，但其中只有26%有固定剂量间隔的镇痛医嘱。观察到医院之间存在差异（p < 0.001）。最常用的镇痛药是安乃近、异丙安替比林、对乙酰氨基酚和可待因。药物选择在年龄和医院方面的差异具有显著性（p < 0.001）。直肠是首选的给药途径。患者年龄与规定的镇痛剂量无关。平均68%的处方已给药，一半未安排镇痛的患者需要给予镇痛药。约20%的患者疼痛评分较高。
很少有儿科患者以固定剂量间隔给予镇痛药来治疗术后疼痛。在开的药物和给药途径方面，儿童的疼痛缓解治疗与成人显著不同。版权所有1999年国际疼痛研究协会欧洲分会联盟。
