Abstract
New research, regulatory guidelines, and practice initiatives have improved pain management
in infants, children, and adolescents, but obstacles remain. The aim of this study
was to identify the prevalence and demographics of pain, as well as pain management
practice patterns in hospitalized children in a tertiary-care university hospital.
We prospectively collected data including patient demographics, presence/absence and
location of pain, pain intensity, pain assessment documentation, analgesic use, side
effects of analgesic therapy, and patient/family satisfaction. Two hundred male (58%)
and female, medical and surgical (61%) patients, averaging 9 ± 6.2 years were studied.
Pain was common (86%) and often moderate to severe (40%). Surgical patients reported
pain more frequently when enrolled than did medical patients (99% vs. 65%). Female
gender, age ≥5 years, and Caucasian race were all associated with higher mean pain
scores. Furthermore, females and Caucasian children consumed more opioids than males
and non-Caucasians. Identified obstacles to optimal analgesic management include lack
of documented physician pain assessment (<5%), a high prevalence of “as needed” analgesic
dosing, frequent opioid-induced side effects (44% nausea and vomiting, 27% pruritus),
and patient/family dissatisfaction with pain management (2%-7%). The data demonstrated
that despite a concentrated focus on improving pain management over the past decade,
pain remains common in hospitalized children. Identification of patient populations
and characteristics that predispose to increased pain (e.g., female, Caucasian, postoperative
patient) as well as obstacles to analgesic management provide a focus for the development
of targeted interventions and research to further improve care.
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Article info
Publication history
Published online: June 11, 2012
Accepted:
April 17,
2012
Received in revised form:
April 16,
2012
Received:
September 21,
2011
Footnotes
Supported by the Jacob and Hilda Blaustein Foundation and the Richard J. Traystman endowed chair in Pediatric Anesthesiology, Critical Care Medicine, and Pain Management.
Identification
Copyright
© 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
