Errors in Managing Postsurgical Pediatric Pain in Mexico

Matus, Carlos A. Bravo; Zúñiga, Rosa María Flores

doi:10.3109/15360288.2011.573528

Cited by 7 publications

(9 citation statements)

References 16 publications

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“…Failure to assess the severity of pain is one of the common concerns in pain management and pain trials in children . The three previously mentioned high‐quality RCTs used a pain score which was validated for the age groups studied (VAS and CHEOPS) .…”

Section: Discussionmentioning

confidence: 99%

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Leeuw

Dirckx

Candel

et al. 2017

Pediatric Anesthesia

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Dipyrone has analgesic, spasmolytic, and antipyretic effects and is used to treat pain. Due to a possible risk of agranulocytosis with the use of dipyrone, it has been banned in a number of countries. The most commonly used data for the use of dipyrone are related to adults. Information relating to the use of dipyrone in children is scarce. Given the potential added value of dipyrone in the treatment of pain, a review of the literature was conducted to obtain more insight into the analgesic efficacy of dipyrone in children as well as the safety of dipyrone in terms of adverse events. A literature search was done for original articles (in English, German, or Spanish language) which met the following criteria: the use of dipyrone for pain and children up to the age of 17 years old. All titles and abstracts retrieved were reviewed, independently, by two of the authors, for their suitability for inclusion. The references of the selected articles were also checked for additional relevant papers. The publications were categorized into case reports, observational studies, or randomized controlled trials. To assess the methodological quality of the studies, the Jadad score was used. In the limited available data, the analgesic efficacy of intravenous dipyrone appears similar to that of intravenous paracetamol. Evidence is lacking to support the claim that dipyrone is equivalent or even superior to Non-Steroid-Anti-Inflammatory-Drugs in pediatric pain. While the absolute risk of agranulocytosis with dipyrone in children, based on available literature, cannot be determined, case reports suggest that this risk is not negligible.

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Section: Discussionmentioning

confidence: 99%

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Leeuw

Dirckx

Candel

et al. 2017

Pediatric Anesthesia

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“…Postoperative pain is a subjective symptom that has been extensively studied in adults but only minimally in children. The use of low analgesic doses and failure to document the pain and its management are common concerns in pediatric patients (4).…”

Section: Discussionmentioning

confidence: 99%

“…In young children who are unable to express pain verbally, crying is sometimes attributed to the mothers' absence, hunger, or the unfamiliar hospital environment rather than pain (4,11,12). Pain in children causes distress not only for them but also for their parents and the medical staff.…”

Section: Discussionmentioning

confidence: 99%

Effects of Suppository Acetaminophen, Bupivacaine Wound Infiltration, and Caudal Block With Bupivacaine on Postoperative Pain in Pediatric Inguinal Herniorrhaphy

et al. 2012

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Background:The control of postoperative pain is important in children, and poor pain control leads to organ dysfunction and behavioral problems. Objectives: We compared the analgesic effects of suppository acetaminophen, bupivacaine wound infiltration, and caudal block with bupivacaine on postoperative pain in pediatric inguinal herniorrhaphy. Patients and Methods:In this double-blinded, randomized controlled clinical trial, 90 children of American Society of Anesthesiologists (ASA) grade I-II, aged between 3 months and 7 years, and scheduled for elective unilateral inguinal herniorrhaphy under general anesthesia were assigned to three equal groups. Patients in the first group received 20 mg/kg of suppository acetaminophen. In the second group, 2 mg/kg of 0.5% bupivacaine was infiltrated in the incisional site, and in the third group, a caudal block was performed with 0.75 mL/kg of 0.25% bupivacaine. The Face, Legs, Activity, Cry, Consolability (FLACC) pain scale was applied 30 minutes after operation. Thereafter, the FLACC score was obtained every hour during the next 6 hours. If the FLACC score was 4 or over, we administered 0.5 mg/kg of intravenous meperidine. The data was transferred to SPSS-10 software and analyzed statistically with chi-square and analysis of variance tests. P < 0.05 was considered significant. Results: The mean analgesic duration in the acetaminophen, bupivacaine infiltration, and caudal block groups was 4.07, 5.40, and 5.37 hours, respectively. Significant differences were not observed between the bupivacaine infiltration and caudal block groups (P = 0.9), but the differences between the bupivacaine infiltration and acetaminophen groups (P = 0.034) and the caudal block and acetaminophen groups (P = 0.039) were significant. With regard to meperidine administration, significant differences were not observed between the bupivacaine infiltration and caudal block groups (P = 0.848), but significant differences were observed between these two groups and the acetaminophen group (P < 0.05). Conclusions: Patients in the bupivacaine infiltration and caudal block groups had less postoperative pain than those in the acetaminophen group and received lower amount of meperidine. We concluded that in children, bupivacaine infiltration and caudal block with bupivacaine produce better analgesia than suppository acetaminophen. It seems that bupivacaine infiltration is better than caudal block because of its simplicity, lower incidence of complications, and failure rate.

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“…[1][2][3][4][5][6][7] Problems with pain management can link to absent of complete a structural pain management program with inadequate close patient monitoring. [8][9][10][11][12][13] There is a wide variety of different analgesics available on the market; dosage forms that range from lollipops to patches; the differences of delivery vehicles from implantable devices to patient-controlled analgesia (PCA), and different routes of administration. It is imperative for hospitals to revise this issue to ensure a safe, efficient, and realistic approach to managing pain.…”

Section: Introductionmentioning

confidence: 99%

KSA-Self Assessment of Pain Management Medication Safety for Hospitals

Alomi¹,

Ibrahim²

2017

JPPCM

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Pain management program is essential and required the program to prevent the adverse event, drug misadventure, and pain killer medications related death at health care institutions. One of the tools to evaluate the performance and drug safety of the pain management program.It is the assessment of ten directions of medication safety including patient information, The tool had a scoring scale system of acceptable or risk level or need improvement with the annual application. The tool is first self-assessment tool of pain management medication in Saudi Arabia. The tool is highly recommended to apply at all government and private hospitals in Kingdom of Saudi Arabia.

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Errors in Managing Postsurgical Pediatric Pain in Mexico

Cited by 7 publications

References 16 publications

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Effects of Suppository Acetaminophen, Bupivacaine Wound Infiltration, and Caudal Block With Bupivacaine on Postoperative Pain in Pediatric Inguinal Herniorrhaphy

KSA-Self Assessment of Pain Management Medication Safety for Hospitals

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