Walther-Larsen S, Pedersen M T, Friis S M, Aagaard G B, Rømsing J, Jeppesen E M, Friedrichsdorf S J
Pediatric Pain Service, Department of Anesthesiology, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2017 Mar;61(3):328-337. doi: 10.1111/aas.12846. Epub 2016 Dec 29.
Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown.
This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed.
Two hundred and thirteen children (37%) responded that they had experienced pain in the previous 24 hours. One hundred and thirty four (24%) indicated moderate to severe pain and 43% would have preferred an intervention to alleviate the pain. In children hospitalized for more than 24 hours, the prevalence of moderate/severe pain was significantly higher compared to children admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation.
This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority of children in moderate to severe pain did not have a documented pain assessment, and evidence-based pharmacological and/or integrative ('non-pharmacological') measures were not systematically administered to prevent or treat pain. Thus, practice changes are needed.
住院儿童的疼痛管理往往不足。丹麦大学医院疼痛的患病率及主要来源尚不清楚。
这项前瞻性混合方法横断面调查在丹麦的四家大学医院进行。我们纳入了570名儿科患者,要求他们报告过去24小时内的疼痛经历及其管理情况。对于被确定为有中度至重度疼痛的患者,对其患者特征和镇痛方案进行了审查。
213名儿童(37%)回答说他们在过去24小时内经历过疼痛。134名(24%)表示有中度至重度疼痛,43%的儿童希望采取干预措施来缓解疼痛。与当天入院的儿童相比,住院超过24小时的儿童中度/重度疼痛的患病率显著更高。儿童提到的最常见的疼痛操作是针刺操作,如抽血和静脉置管。
这项研究揭示了丹麦四家大学医院收治的所有年龄组儿童中疼痛患病率很高。大多数中度至重度疼痛的儿童没有记录疼痛评估,基于证据的药物和/或综合(“非药物”)措施没有系统地用于预防或治疗疼痛。因此,需要改变做法。