Schechter N L, Allen D A, Hanson K
Pediatrics. 1986 Jan;77(1):11-5.
A chart review was conducted of the records of 90 children and 90 adults, randomly selected and matched for sex and diagnosis, to investigate analgesic usage. Four diagnostic categories (hernias, appendectomies, burns, and fractured femurs) at two hospitals were examined. Results revealed that adults received an average of 2.2 doses of narcotics per day, whereas children received 1.1 (P = .0001). Significant differences in dosing were noted between the diagnostic categories. Diagnoses associated with a longer hospital stay showed a greater discrepancy between narcotic usage in children and adults. Hospital differences were also significant (P = .004) with more doses per day administered at the urban hospital than the rural one. Infants and young children were less likely than older children to have narcotics ordered for them, but, if ordered, frequency of administration was similar for all children. Our study demonstrates that children and adults with the same diagnoses are treated differently as regards narcotic administration. Further research is necessary to determine whether these results represent a difference in pain tolerance in children or a lack of recognition of their discomfort.
对90名儿童和90名成人的病历进行了图表回顾，这些儿童和成人是随机选取的，在性别和诊断方面进行了匹配，以调查镇痛药物的使用情况。对两家医院的四个诊断类别（疝气、阑尾切除术、烧伤和股骨骨折）进行了检查。结果显示，成人每天平均接受2.2剂麻醉药，而儿童接受1.1剂（P = 0.0001）。在不同诊断类别之间发现了给药剂量的显著差异。与住院时间较长相关的诊断显示，儿童和成人在麻醉药使用方面的差异更大。医院之间的差异也很显著（P = 0.004），城市医院每天的给药剂量比农村医院多。婴幼儿比大龄儿童接受麻醉药医嘱的可能性小，但如果有医嘱，所有儿童的给药频率相似。我们的研究表明，患有相同诊断的儿童和成人在麻醉药给药方面受到不同的治疗。有必要进行进一步的研究，以确定这些结果是代表儿童疼痛耐受性的差异，还是对他们不适的认识不足。
