Finley Allen G, McGrath Patrick J, Forward Paula S, McNeill Gillian, Fitzgerald Peter
Department of Anaesthesia Canada Psychology, Izaak Walton Killam Children's Hospital and Dalhousie University, Halifax B3J 3G9 Canada Department of Surgery, Children's Hospital at Chedoke-McMaster, Hamilton Ontario L8N 3Z9 Canada.
Pain. 1996 Jan;64(1):83-87. doi: 10.1016/0304-3959(95)00091-7.
The aim of the investigation was to evaluate the prevalence, severity, and parents' management of children's pain following short-stay and day surgery. The subjects were 189 parents of children (2-12 years of age) who had undergone short-stay or day surgery. Parents completed a 3-day diary of their child's pain and the methods used to alleviate it. There were clear differences in pain reported according to type of surgery. Some surgery, such as insertion of myringotomy tubes, appeared to cause little pain. Other procedures, including tonsillectomy, circumcision, and strabismus repair, resulted in about one-half the children experiencing clinically significant pain (> or = 30 mm on a 100 mm VAS). Sixty-eight percent of the parents reported they had been instructed to use acetaminophen for pain 'if necessary', 13% had been told to use acetaminophen regularly, and 8% recalled no instructions. Of the parents who rated their child's pain as significant, 13% administered no pain medication and 47% gave 1-3 doses on day 2. On day 3, 17% gave no medication and 45% gave 1-3 doses. Some types of 'minor' surgery result in significant pain postoperatively. Even when parents recognise that their children are in pain, most give inadequate doses of medication to control the pain.
该调查的目的是评估短期住院和日间手术后儿童疼痛的发生率、严重程度以及家长的应对措施。研究对象为189名接受过短期住院或日间手术的2至12岁儿童的家长。家长们记录了孩子3天的疼痛情况以及缓解疼痛所采用的方法。根据手术类型，报告的疼痛情况存在明显差异。一些手术，如鼓膜切开置管术，似乎引起的疼痛较小。而其他手术，包括扁桃体切除术、包皮环切术和斜视矫正术，约有一半的儿童经历了临床上显著的疼痛（在100毫米视觉模拟评分法上≥30毫米）。68%的家长表示他们被指示“必要时”使用对乙酰氨基酚缓解疼痛，13%的家长被告知定期使用对乙酰氨基酚，8%的家长回忆说没有得到任何指示。在那些认为孩子疼痛严重的家长中，13%未给孩子服用任何止痛药物，47%在第二天给孩子服用了1至3剂药物。在第三天，17%未给孩子服药，45%给孩子服用了1至3剂药物。某些类型的“小”手术术后会导致明显疼痛。即使家长意识到孩子疼痛，大多数人给予的药物剂量也不足以控制疼痛。
