Bailey Lucas, Sun Jing, Courtney Mark, Murphy Paul
Gold Coast University Hospital and Griffith University, School of Medicine, Queensland, Australia.
Griffith University, School of Medicine and Menzies Health Institute Queensland, Australia; Beijing Jingdu Children's Hospital, Beijing, China.
Int J Pediatr Otorhinolaryngol. 2015 May;79(5):732-9. doi: 10.1016/j.ijporl.2015.03.003. Epub 2015 Mar 7.
To evaluate paediatric post-tonsillectomy pain management using oxycodone when a specific analgesia information sheet is included with standard postoperative information.
Oxycodone information sheets were randomly allocated to half the study children's post-tonsillectomy information pack. The trial was double-blinded to the surgeon, anaesthetist, nursing and administrative staff. Parents and children completed the pain assessment on day 3, 5 and 7. On day 10 the parents completed a questionnaire.
A postoperative analgesia information sheet provides for higher satisfaction and knowledge for parents using oxycodone (p<0.001) and children have improved postoperative pain control, most significantly at day 5 (p<0.05). Parent assessment of the child's analgesia was superior with the oxycodone information sheet, most significantly at day 3 and 7 post operatively (p<0.05). There is also a positive correlation between the parents' observed pain score and children's self reported pain score, with a low correlation efficient level observed (p<0.001).
Information sheets are useful in education and use of postoperative analgesia. The primary objective to explore the efficacy of the information sheet has proved to be successful in this setting. Given risks of opioid analgesia, it is recommended that postoperative information sheets be given to all parents, to provide for improved analgesia control and safe management of children in the postoperative period.
当标准术后信息中包含特定的镇痛信息表时,评估使用羟考酮进行小儿扁桃体切除术后疼痛管理的效果。
羟考酮信息表被随机分配到一半研究儿童的扁桃体切除术后信息包中。该试验对外科医生、麻醉师、护理和行政人员进行双盲。家长和孩子在第3、5和7天完成疼痛评估。在第10天,家长完成一份问卷。
术后镇痛信息表使使用羟考酮的家长满意度更高、知识掌握更好(p<0.001),且孩子术后疼痛控制得到改善,在第5天最为显著(p<0.05)。使用羟考酮信息表时,家长对孩子镇痛情况的评估更优,在术后第3天和第7天最为显著(p<0.05)。家长观察到的疼痛评分与孩子自我报告的疼痛评分之间也存在正相关,且相关系数较低(p<0.001)。
信息表在术后镇痛的教育和使用中很有用。在这种情况下,探索信息表疗效的主要目标已被证明是成功的。鉴于阿片类镇痛药的风险,建议向所有家长提供术后信息表,以改善镇痛控制并在术后对儿童进行安全管理。