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使用智能手机应用程序接受门诊手术的儿童报告的疼痛随访:AlgoDARPEF 多中心描述性前瞻性研究。

A follow-up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF multicenter descriptive prospective study.

机构信息

Department of Pediatric Anaesthesia and Intensive Care, Clinique Saint George, Nice, France.

INSERM U1065 Université Côte d'Azur; Department of Anaesthesia and Intensive Care, University Hospital of Nice, Nice, France.

出版信息

Pain. 2022 Nov 1;163(11):2224-2231. doi: 10.1097/j.pain.0000000000002620. Epub 2022 Mar 1.

Abstract

In pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children younger than 18 years scheduled for an elective outpatient procedure in one of the participating centers were eligible. Parents were invited to provide daily information for 10 days regarding their child's pain and comfort through a smartphone App using the Parents' Postoperative Pain Measure-Short-Form (PPPM-SF). Children older than 6 years could also provide self-assessments of pain using a numerical rating scale (NRS)-11. Data regarding pain medication, preoperative anxiety, postoperative nausea and vomiting, and parent satisfaction were also analyzed. Repeated-measures analyses of variances (ANOVAs) were used to compare the self-assessments and hetero-assessments of pain. Eleven centers participated in the study, and 1573 patients were recruited. Forty-nine percentage of parents (n = 772) actually used the App at least once. In all surgeries, the average pain rating on the PPPM-SF scale did not exceed 3/10 throughout the follow-up period, as well as for 4 main surgical specialties. Age, visceral surgery, and preoperative anxiety ≥ 4/10 were identified as independent risk factors for experiencing at least 1 episode of pain ≥4/10 during the first 48 postoperative hours. Although these findings indicated that postoperative pain management seems to be satisfactory in the families who used the App, some improvements in anxiety management are suggested. This study shows that inviting parents to use a smartphone App to assess and report the quality of postoperative management in pediatric patients provides useful information. A continuous report regarding pain and adverse events over a 10-day postoperative period by a self-reporting or parent's contribution is possible. Future studies should investigate the ability of live data collection using an App to ensure fast, efficient interactions between patients and physicians.

摘要

在儿科患者中,疼痛仍然是手术后最常见的主诉。这项法国多中心的流行病学研究(AlgoDARPEF)旨在评估使用智能手机应用程序(App)评估接受门诊手术的儿童经历的疼痛持续时间和严重程度。有资格参与的是计划在参与中心之一接受择期门诊手术的 18 岁以下儿童。通过使用父母术后疼痛测量-短表(PPPM-SF)的智能手机 App,邀请父母在 10 天内每天提供有关孩子疼痛和舒适度的信息。6 岁以上的儿童也可以使用数字评分量表(NRS)-11 进行自我评估疼痛。还分析了疼痛药物、术前焦虑、术后恶心和呕吐以及家长满意度的数据。使用重复测量方差分析(ANOVA)比较自我评估和异源评估的疼痛。11 个中心参与了这项研究,共招募了 1573 名患者。实际上至少使用过一次 App 的父母比例为 49%(n=772)。在所有手术中,整个随访期间 PPPM-SF 量表上的平均疼痛评分均未超过 3/10,4 种主要手术专科也是如此。年龄、内脏手术和术前焦虑≥4/10 被确定为术后前 48 小时内至少经历 1 次≥4/10 疼痛发作的独立危险因素。尽管这些发现表明使用 App 的家庭的术后疼痛管理似乎令人满意,但建议改善焦虑管理。本研究表明,邀请家长使用智能手机 App 评估和报告儿科患者术后管理质量可提供有用信息。可以通过自我报告或父母的贡献在 10 天的术后期间持续报告疼痛和不良事件。未来的研究应该调查使用 App 进行实时数据收集的能力,以确保患者和医生之间快速、高效的互动。

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