Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, United States of America.
J Pediatr Nurs. 2019 May-Jun;46:e10-e14. doi: 10.1016/j.pedn.2019.01.014. Epub 2019 Mar 6.
This study compares the current practice patterns of pain assessment and management between children with and without CP following either posterior spinal instrumentation and fusion (PSIF) or hip osteotomy (HO).
Two cohorts of CP patients were retrospectively identified and matched with non-CP patients based on age, surgical procedure, and approach to post-operative pain management. Sixteen CP patients undergoing PSIF and twenty-two undergoing HO were respectively matched with the same numbers of non-CP patients receiving the same procedures. The frequency of assessments conducted, highest pain scores recorded on each post-operative day (POD), and the amount of adjuvant analgesics administered were collected for POD 0-4.
Patients with CP were significantly more frequently evaluated for pain post-operatively, tended to have lower pain scores as measured by current scales, and received slightly fewer analgesics. Patients with CP differed from their non-CP counterparts in both frequency and method of post-operative pain assessment.
The purpose of this study is to elucidate the current state of post-operative pain assessment and management in children with CP undergoing major orthopaedic surgeries, to improve CP patient/caregiver understanding and expectation of the post-operative experience regarding pain, and to provide recommendations for improving the post-operative care for these patients.
本研究比较了 CP 患儿与非 CP 患儿在接受后路脊柱内固定融合术（PSIF）或髋关节截骨术（HO）后，疼痛评估和管理的现行实践模式。
回顾性地确定了两个 CP 患者队列，并根据年龄、手术程序以及术后疼痛管理方法与非 CP 患者进行匹配。分别对接受 PSIF 的 16 例 CP 患儿和接受 HO 的 22 例 CP 患儿进行了匹配，各匹配了接受相同手术的相同数量的非 CP 患儿。收集了 POD0-4 时进行的评估频率、每个术后日（POD）记录的最高疼痛评分和辅助镇痛药物的使用量。
CP 患儿术后疼痛评估的频率明显更高，使用现有量表测量的疼痛评分较低，且使用的镇痛药略少。CP 患儿在术后疼痛评估的频率和方法上与非 CP 患儿存在差异。
本研究旨在阐明 CP 患儿在接受重大骨科手术后术后疼痛评估和管理的现状，以提高 CP 患儿及其家属对术后疼痛体验的理解和期望，并为改善这些患者的术后护理提供建议。
