scholarly journals Pain assessment and management in children in the postoperative period: A review of the most commonly used postoperative pain assessment tools, new diagnostic methods and the latest guidelines for postoperative pain therapy in children

2020 ◽  
Vol 29 (3) ◽  
pp. 365-374 ◽  
Author(s):  
Jakub Zieliński ◽  
Monika Morawska-Kochman ◽  
Tomasz Zatoński
Keyword(s):  
Postoperative Pain ◽  
Postoperative Period ◽  
Pain Assessment ◽  
Pain Therapy ◽  
Diagnostic Methods ◽  
Assessment Tools ◽  
Postoperative Pain Therapy

scholarly journals Assessment of pain during rest and during activities in the postoperative period of cardiac surgery

2014 ◽  
Vol 22 (1) ◽  
pp. 136-143 ◽  
Author(s):  
Larissa Coelho de Mello ◽  
Silvio Fernando Castro Rosatti ◽  
Priscilla Hortense
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Pain Assessment ◽  
Descriptive Study ◽  
Deep Breathing ◽  
Cohort Design ◽  
Surgical Recovery ◽  
Over Time

OBJECTIVE: to assess the intensity and site of pain after Cardiac Surgery through sternotomy during rest and while performing five activities. METHOD: descriptive study with a prospective cohort design. A total of 48 individuals participated in the study. A Multidimensional Scale for Pain Assessment was used. RESULTS: postoperative pain from cardiac surgery was moderate during rest and decreased over time. Pain was also moderate during activities performed on the 1st and 2nd postoperative days and decreased from the 3rd postoperative day, with the exception of coughing, which diminished only on the 6th postoperative day. Coughing, turning over, deep breathing and rest are presented in decreased order of intensity. The region of the sternum was the most frequently reported site of pain. CONCLUSION: the assessment of pain in the individuals who underwent cardiac surgery during rest and during activities is extremely important to adapt management and avoid postoperative complications and delayed surgical recovery.

Metamizole for postoperative pain therapy in 1177 children

2015 ◽  
Vol 32 (12) ◽  
pp. 839-843 ◽  
Author(s):  
Melanie Fieler ◽  
Christoph Eich ◽  
Karin Becke ◽  
Gregor Badelt ◽  
Klaus Leimkühler ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Therapy ◽  
Postoperative Pain Therapy

Postoperative Pain Therapy by Epidural Morphine

1982 ◽  
pp. 109-113
Author(s):  
M. Zenz ◽  
S. Piepenbrock ◽  
G. Otten ◽  
M. Hüsch
Keyword(s):  
Postoperative Pain ◽  
Epidural Morphine ◽  
Pain Therapy ◽  
Postoperative Pain Therapy

Effectiveness of postoperative pain therapy in children assessed by their parents – is inadequate analgesia potentially dangerous?

Ból ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 17-24
Author(s):  
Michał Zięba ◽  
Artur Baranowski ◽  
Magdalena Mierzewska-Schmidt
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Postoperative Analgesia ◽  
Sleep Disturbances ◽  
Parental Education ◽  
Pain Therapy ◽  
Rating Scale ◽  
Likert Scale ◽  
Assessment Tools ◽  
University Hospital

Inadequate pain therapy can lead to negative physical and psychological consequences, increase complications and even mortality. We aimed to assess effectiveness of postoperative analgesia in children from their parents’ point of view. We also wanted to evaluate their degree of satisfaction of postoperative analgesia and to identify areas for improvement. Patients’ parents (n = 85) from Paediatric University Hospital in Warsaw, Poland, took part in our survey. They evaluated pain intensity on five-point Likert Scale and on numerical rating scale (NRS). Mean value of pain on NRS was 4.22 (SD±2,53). On Likert scale the majority of parents described pain intensity as moderate. High percentage (38.82%) of children were in pain while their parents took the survey and only 19% of children did not feel pain at all. In 36 children (42.36%) pain caused sleep disturbances. In same cases non-pharmacological methods of analgesia were effective. Due to inadequate pain relief one of the parents arbitrarily administered a formulation containing paracetamol and codeine. The study revealed low efficacy of analgesia among children of surveyed parents. Their level of satisfaction was inadequately high (91% of them were „very satisfied” or “rather satisfied”). The survey confirmed the need for systematic pain assessment tools. Parental education seems necessary to make them aware that postoperative pain can be treated effectively. Administration of drugs without consulting medical staff is dangerous. It may result in the use of contraindicated agents (as in the case described), drug overdose or unexpected interactions.

Patient-controlled Analgesia with Target-controlled Infusion of Hydromorphone in Postoperative Pain Therapy

2016 ◽  
Vol 124 (1) ◽  
pp. 56-68 ◽  
Author(s):  
Christian Jeleazcov ◽  
Harald Ihmsen ◽  
Teijo I. Saari ◽  
Doris Rohde ◽  
Jan Mell ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Therapy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Plasma Concentrations ◽  
Maximum Plasma ◽  
Patient Controlled Analgesia ◽  
Postoperative Pain Therapy ◽  
Target Controlled Infusion ◽  
Plasma Target

Abstract Background Patient-controlled analgesia (PCA) is a common method for postoperative pain therapy, but it is characterized by large variation of plasma concentrations. PCA with target-controlled infusion (TCI-PCA) may be an alternative. In a previous analysis, the authors developed a pharmacokinetic model for hydromorphone. In this secondary analysis, the authors investigated the feasibility and efficacy of TCI-PCA for postoperative pain therapy with hydromorphone. Methods Fifty adult patients undergoing cardiac surgery were enrolled in this study. Postoperatively, hydromorphone was applied intravenously during three sequential periods: (1) as TCI with plasma target concentrations of 1 to 2 ng/ml until extubation; (2) as TCI-PCA with plasma target concentrations between 0.8 and 10 ng/ml during the following 6 to 8 h; and (3) thereafter as PCA with a bolus dose of 0.2 mg until the next morning. During TCI-PCA, pain was regularly assessed using the 11-point numerical rating scale (NRS). A pharmacokinetic/pharmacodynamic model was developed using ordinal logistic regression based on measured plasma concentrations. Results Data of 43 patients aged 40 to 81 yr were analyzed. The hydromorphone dose during TCI-PCA was 0.26 mg/h (0.07 to 0.93 mg/h). The maximum plasma target concentration during TCI-PCA was 2.3 ng/ml (0.9 to 7.0 ng/ml). The NRS score under deep inspiration was less than 5 in 83% of the ratings. Nausea was present in 30%, vomiting in 9%, and respiratory insufficiency in 5% of the patients. The EC50 of hydromorphone for NRS of 4 or less was 4.1 ng/ml (0.6 to 12.8 ng/ml). Conclusion TCI-PCA with hydromorphone offered satisfactory postoperative pain therapy with moderate side effects.

scholarly journals Recent Advances in Postoperative Pain Therapy for Thoracic Surgery

2014 ◽  
Vol 4 (2) ◽  
pp. 177-187
Author(s):  
Torsten Loop ◽  
Stephen Harris ◽  
Alexander Grimm
Keyword(s):  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Pain Therapy ◽  
Postoperative Pain Therapy ◽  
Recent Advances
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