scholarly journals Perioperative analgesia and assessment of pain in children (literature review)

2021 ◽  
Vol 25 (2) ◽  
pp. 329-335
Author(s):  
O. S. Goncharuk
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Perioperative Analgesia ◽  
Pain Scales ◽  
Nociceptive Responses

Annotation. Adequacy of postoperative analgesia and pain assessment remains a pressing issue in children. In order to provide effective pain management to this population, it is important to consider some specific features such as the age of a child, cognitive imparement, mechanisms of pain, and traumatic cimcumstances resulted in nociceptive responses. Therefore, it is essential for clinicians to be able to choose the appropriate tools for pain assessment in different age groups of children and clinical situations, and to interpret the obtained data correctly. Hence, our study aimed to systematize existing problematic aspects of postoperative pain assessment is children and to analyze the evidence on perioperative analgesia in the paediatic practice. For this purpose, we systematically searched MEDLINE, the Cochrane Library and Google Scholar for trials published between 2002-2020. We paid particular attention to the correct choice of pain assessment tools in children of different age groups, and proper interpretation of the data obtained. The study contains the updated recommendations for postoperative pain management in children. There is a special emphasis on priority of multimodal analgesia in children. Analysis of recent publications shows that newborns and children under 5 years of age should be assessed with comprehensive pain scales that include behavioral characteristics and physiological parameters. It is advisable to use self-assessment pain scales for children older than 5 years of age. In order to manage the acute pain effectively, it should be assessed at least every 4-6 hours. Sufficient perioperative analgesia promotes rapid rehabilitation and prevents children from postoperative homeostatic disruption.

Postoperative pain documentation in a hospital setting: A topical review

2016 ◽  
Vol 11 (1) ◽  
pp. 77-89 ◽  
Author(s):  
Kristiina Heikkilä ◽  
Laura-Maria Peltonen ◽  
Sanna Salanterä
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Hospital Setting ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Topical Review ◽  
Pain Documentation

AbstractBackground and aimsNursing documentation supports continuity of care and provides important means of communication among clinicians. The aim of this topical review was to evaluate the published empirical studies on postoperative pain documentation in a hospital setting.MethodsThe review was conducted through a systematic search of electronic databases: Web of Science, PubMed/Medline, CINAHL, Embase, Ovid/Medline, Scopus and Cochrane Library. Ten studies were included. Study designs, documented postoperative pain information, quality of pain documentation, reported quality of postoperative pain management and documentation, and suggestions for future research and practice improvements were extracted from the studies.ResultsThe most commonly used study design was a descriptive retrospective patient record review. The most commonly reported types of information were pain assessment, use of pain assessment tools, useof pain management interventions, reassessment, types of analgesics used, demographic information and pain intensity. All ten studies reported that the quality of postoperative pain documentation does not meet acceptable standards and that there is a need for improvement. The studies found that organization of regular pain management education for nurses is important for the future.ConclusionsPostoperative pain documentation needs to beimproved. Regular educational programmes and development of monitoring systems for systematic evaluation of pain documentation are needed. Guidelines and recommendations should be based on the latest research evidence, and systematically implemented into practice.ImplicationsComprehensive auditing tools for evaluation of pain documentation can make quality assessment easier and coherent. Specific and clear documentation guidelines are needed and existing guidelines should be better implemented into practice. There is a need to increase nurses’ knowledge of postoperative pain management, assessment and documentation. Studies evaluating effectiveness of high quality pain documentation are required.

Acute Pain Management

2018 ◽  
Author(s):  
Nihar Patel
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Treatment Options ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Age Appropriate ◽  
Short And Long Term ◽  
Inflammatory Drugs ◽  
Postoperative Setting

Age-appropriate pain assessment and management is vital in the care of children with acute pain. Pain in children should be routinely and regularly assessed, documented, treated and reassessed with clear documentation. Poor pain management in the acute and postoperative setting can result in both short- and long-term consequences. The most effective analgesia plans are multimodal. This chapter focuses on the variety of treatment options for pain in the acute setting. Topics covered include age-appropriate pain assessment tools for children; the basics of age-appropriate pain management in children; as well as the role of opioids, nonsteroidal anti-inflammatory drugs, and patient-controlled analgesia in acute and postoperative pain management in children.

Acute paediatric pain management

2017 ◽  
Author(s):  
Tom G. Hansen
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Regional Anaesthesia ◽  
Pain Threshold ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Psychological Needs ◽  
Long Term Effects

Paediatric pain management has made great strides in the past few decades in the understanding of developmental neurobiology, developmental pharmacology, the use of analgesics in children, the use of regional techniques in children, and of the psychological needs of children in pain. The consequences of a painful experience on the young nervous system are so significant that long-term effects can occur, resulting in behavioural changes and a lowered pain threshold for months after a painful event. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain are constantly being refined, with newer drugs being used alone and in combination with other drugs, and continue to be explored. Systemic opioids, paracetamol, non-steroidal anti-inflammatories, and regional anaesthesia alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are often best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The safe and effective management of pain in children includes the prevention, recognition, and assessment of pain; early and individualized treatment; and evaluation of the efficacy of treatment. This chapter discusses selected topics in paediatric acute pain management, with more specific emphasis placed on pharmacology and regional anaesthesia in the treatment of acute postoperative pain management.

scholarly journals Post-operative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review

2020 ◽  
Author(s):  
Gauhar Afshan ◽  
Robyna Irshad Khan ◽  
Aliya Ahmed ◽  
Ali Sarfraz Siddiqui ◽  
Azhar Rehman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Adult Patients ◽  
Cochrane Library ◽  
Regional Analgesia ◽  
Post Operative Pain

Abstract Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade. Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal skill program. Total of 51 clinical trials were included after applying inclusion/exclusion criteria. Results:Results are charted according to the type of surgery. Eleven trials on laparoscopic cholecystectomy used multimodal analgesia including some form of regional analgesia. Different analgesic modalities were studied in 4 trials on thoracotomy, but none used multimodal approach. In 11 trials on laparotomy, multimodal analgesia was employed along with the studied modalities. In 2 trials on hysterectomy, preemptive pregabalin or gabapentin were used for reduction in rescue analgesia. In 13 trials on breast surgical procedures and 10 on orthopaedic surgery, multimodal analgesia was used with some form of regional analgesia. Conclusion: We found that over the past 10 years, clinical trials for postoperative pain modalities have evolved in LMIC according to the current postoperative pain management guidelines i.e. multi-modal approach with some form of regional analgesia. The current review shows that clinical trials were conducted using multimodal analgesia including but not limited to some form of regional analgesia for postoperative pain in LMIC however this research snapshot (of only three countries) may not exactly reflect the clinical practices in all 47 countries. Post Operative Pain Management Modalities Employed in Clinical Trials for Adult Patients in LMIC; A Systematic Review

scholarly journals Post-operative pain management modalities employed in clinical trials for adult patients in LMIC: a systematic review

2020 ◽  
Author(s):  
Gauhar Afshan ◽  
Robyna Irshad Khan ◽  
Aliya Ahmed ◽  
Ali Sarfraz Siddiqui ◽  
Azhar Rehman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Cochrane Library ◽  
Clinical Practices ◽  
Regional Analgesia ◽  
Rescue Analgesia

Abstract Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade. Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal skill program. Total of 51 clinical trials were included after applying inclusion/exclusion criteria. Results: Results are charted according to the type of surgery. Eleven trials on laparoscopic cholecystectomy used multimodal analgesia including some form of regional analgesia. Different analgesic modalities were studied in 4 trials on thoracotomy, but none used multimodal approach. In 11 trials on laparotomy, multimodal analgesia was employed along with the studied modalities. In 2 trials on hysterectomy, preemptive pregabalin or gabapentin were used for reduction in rescue analgesia. In 13 trials on breast surgical procedures and 10 on orthopaedic surgery, multimodal analgesia was used with some form of regional analgesia. Conclusion: We found that over the past 10 years, clinical trials for postoperative pain modalities have evolved in LMIC according to the current postoperative pain management guidelines i.e. multi-modal approach with some form of regional analgesia. The current review shows that clinical trials were conducted using multimodal analgesia including but not limited to some form of regional analgesia for postoperative pain in LMIC however this research snapshot (of only three countries) may not exactly reflect the clinical practices in all 47 countries.

scholarly journals Post-operative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gauhar Afshan ◽  
Robyna Irshad Khan ◽  
Aliya Ahmed ◽  
Ali Sarfraz Siddiqui ◽  
Azhar Rehman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Adult Patients ◽  
Cochrane Library ◽  
Regional Analgesia ◽  
Post Operative Pain

Abstract Background Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade. Methods A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal skill program. Total of 51 clinical trials were included after applying inclusion/exclusion criteria. Results Results are charted according to the type of surgery. Eleven trials on laparoscopic cholecystectomy used multimodal analgesia including some form of regional analgesia. Different analgesic modalities were studied in 4 trials on thoracotomy, but none used multimodal approach. In 11 trials on laparotomy, multimodal analgesia was employed along with the studied modalities. In 2 trials on hysterectomy, preemptive pregabalin or gabapentin were used for reduction in rescue analgesia. In 13 trials on breast surgical procedures and 10 on orthopaedic surgery, multimodal analgesia was used with some form of regional analgesia. Conclusion We found that over the past 10 years, clinical trials for postoperative pain modalities have evolved in LMIC according to the current postoperative pain management guidelines i.e. multi-modal approach with some form of regional analgesia. The current review shows that clinical trials were conducted using multimodal analgesia including but not limited to some form of regional analgesia for postoperative pain in LMIC however this research snapshot (of only three countries) may not exactly reflect the clinical practices in all 47 countries. Post Operative Pain Management Modalities Employed in Clinical Trials for Adult Patients in LMIC; A Systematic Review.

CRIES: A Neonatal Postoperative Pain Measurement Score

2018 ◽  
pp. 263-267
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Reliable Method ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Neonatal Pain ◽  
Reliable Assessment ◽  
Assessment And Treatment ◽  
Neonatal Population

This case focuses on neonatal pain management by asking the question: Is the CRIES score a valid and reliable method for assessing neonatal postoperative pain? Regular pain assessment and treatment in the neonatal population are important postoperatively. The CRIES scale was designed to measure pain in the neonatal population, and this study demonstrated CRIES to be a valid and reliable assessment tool for identifying postsurgical pain in neonates. Multiple pain assessment tools, including CRIES, are available for use in neonatal patients and in patient populations who are otherwise unable to verbalize discomfort.

scholarly journals Post-operative Paediatric Pain Assessment and Management at a Tertiary Health Facility, Southern Nigeria: Surgeons’ Perspectives and Practice

2020 ◽  
pp. 35-42
Author(s):  
G. K. Eke ◽  
P. E. Okoro
Keyword(s):  
Postoperative Pain ◽  
Health Facility ◽  
Postoperative Analgesia ◽  
Pain Assessment ◽  
Opioid Analgesics ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Southern Nigeria

Introduction: Whereas advances in perioperative care of children continue to be made with increasing evidence-based practice for postoperative analgesia, inadequate relief of postoperative pain resulting in significant morbidity and mortality is still being reported. Objective: To appraise surgeons' perspectives and practice of paediatric post-operative pain assessment and management at a tertiary health facility in southern Nigeria. Methods: In this cross-sectional survey carried out between September and December 2019, a semi-structured and self-administered questionnaire was distributed to surgeons/trainees in departments/units where paediatric patients undergo both major and minor surgeries. Their perspectives and practice of postoperative pain assessment and management were analysed using SPSS version 20.0. Results: Seventy-nine respondents completed the survey, including 19(24%) consultants, 32(40.5%) senior registrars, and 22(27.9%) junior registrars. Two-third of respondents (n=51, 64.6%) had more than 10 years working experience post-graduation. Involving parents/caregivers to assess postoperative pain was the most common strategy used by respondents (n=69, 87.3%), and most of them (n=67, 84.8%) do not make use of any pain assessment tools.  Non-pharmacologic strategies for postoperative pain management were applied/prescribed sometimes (n=20, 25%) or rarely (n=20, 25%). Paracetamol and NSAIDs were the commonest non-opioid analgesics used while pentazocine was the commonly used opioid. Many respondents (n=66, 83.5%) had never prescribed morphine for postoperative analgesia in children. Seventeen percent of respondents do not prescribe postoperative analgesia to newborns. Conclusion: Findings of this study show that the practice in our institution falls short of the recommended multimodal approach to paediatric postoperative pain care. Development of standard protocols and training of providers of postoperative care are recommended.

scholarly journals Postoperative Pain Management among Registered Nurses in a Vietnamese Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Phuong Hoang Vu ◽  
Duc Viet Tran ◽  
Yen Thi Le ◽  
Ha Thi Thu Do ◽  
Sao Thi Vu ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Registered Nurses ◽  
Management Practices ◽  
Rating Scale ◽  
Management Practice ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Urban Hospital

This study examined the postoperative pain management practices among registered nurses in an urban hospital in Vietnam. Data of 90 nurses about postoperative pain management practices and pain management at the department were collected. Results indicated that 83.3% of nurses reported that they regularly assessed the degree of pain for postoperative patients. Only 32.2% used assessment tools such as the numeric rating scale to measure pain. Experience in pain management and having guidelines in the department were associated with a higher score in pain management practice. Findings suggested that facilitating the use of pain instruments and developing pain management guidelines should be prioritized.

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