Managing acute pain in children presenting to the emergency department without opioids

Chumpitazi, Corrie E.; Chang, Cindy D.; Atanelov, Zaza; Dietrich, Ann; Lam, Samuel H.F.; Rose, Emily; Ruttan, Tim; Shahid, Sam; Stoner, Michael J.; Sulton, Carmen; Saidinejad, Mohsen

doi:10.1002/emp2.12664

Cited by 11 publications

(6 citation statements)

References 97 publications

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“… The Richmond Agitation-Sedation Scale (RASS) score was used to assess the patient agitation, and the total scores were 0–10 points. The higher the score, the more severe the agitation [ 7 , 8 , 10 , 11 ]. The adverse events of the children were recorded Parent satisfaction: the self-administered satisfaction questionnaire with a total score of 0–10 points was provided.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision

Yao

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the efficacy of dexmedetomidine anesthesia plus dorsal penile nerve block in pediatric circumcision. Methods. In this retrospective study, 80 children receiving circumcision in our hospital from February 2020 to February 2021 were recruited and assigned via different anesthesia methods at a ratio of 1 : 1 to receive dorsal penile nerve block plus dexmedetomidine anesthesia (combined anesthesia group) or only sevoflurane for total inhalational anesthesia (total anesthesia group). Traditional Chinese medicine (TCM) care was introduced to both groups of patients. Outcome measures included vital signs, operative indices, anesthesia effect, adverse reactions, parent satisfaction, and nursing satisfaction. Results. There were no significant differences in the heart rate, oxygen saturation, and mean arterial pressure between the two groups of children before anesthesia, after anesthesia, and during the awakening period ( P > 0.05 ). Patients receiving combined anesthesia showed a shorter time lapse before the disappearance of eyelash reflex, longer time lapse before postoperative analgesic use, faster awakening, and shorter operation time and hospital stay versus those receiving total inhalational anesthesia alone ( P > 0.05 ). The combined anesthesia resulted in a lower Induction Compliance Checklist (ICC) score, McGill score, and Richmond Agitation-Sedation Scale (RASS) score and a higher Ramsay score versus total anesthesia ( P > 0.05 ). Patients receiving combined anesthesia showed a significantly lower incidence of adverse events (5.00% (2/40)) versus total inhalational anesthesia (62.50% (25/40)) (X2 = 29.574, P > 0.05 ). The combined anesthesia group had a higher parent satisfaction (92.50% (37/40)) versus the total anesthesia group (75.00% (30/40)) (X2 = 4.501, P > 0.05 ). A total of 80 questionnaires were distributed, with a 100% return rate and a 100% validity rate, and all 80 questionnaires scored 90 points or above. The families of children in both groups were satisfied with the quality of TCM care. Conclusion. The efficacy of dorsal penile nerve block plus dexmedetomidine anesthesia in pediatric circumcision is better than total inhalational anesthesia with sevoflurane.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision

Yao

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Dodatkowo badania opisały lepsze wyniki funkcjonalne oraz znacznie mniejszą liczbę działań niepożądanych podczas stosowania niesteroidowych leków przeciwzapalnych w porównaniu do leków opioidowych w leczeniu schorzeń tego układu. [14], [16] Opioidowe leki przeciwbólowe stanowią kolejną grupę leków stosowanych w populacji pediatrycznej. Ich głównym zastosowaniem jest uśmierzanie bólu ciężkiego i umiarkowanego wynikającego zarówno z ostrych i przewlekłych zespołów bólowych a także bólu pooperacyjnego.…”

Section: Leczenie Farmakologiczneunclassified

Pain therapy in the pediatric population

Białowąs

Mazurek²,

Aghadi³

et al. 2023

J Educ Health Sport

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Introduction: The assessment and treatment of pain in the pediatric population is a huge challenge for doctors and medical staff dealing with this group of patients. It is also one of the most important elements of pediatric care practice. There are many factors that contribute to the difficulty of assessing and managing pain in children, but the most important seems to be the lack of unified standards of care. In pain therapy, both pharmacotherapy and behavioral methods and psychological care are used. Purpose of the work: The aim of this work is to systematize the current state of knowledge in the field of pain therapy in the pediatric population, focusing particular attention on pharmacotherapy Materials and Evidence: We reviewed the literature available in the PubMed database using the following keywords: pediatric; pain therapy; analgesia Summary: Pain therapy in the pediatric population, despite the fact that it is often underestimated and insufficiently managed, is crucial both in terms of avoiding health complications and in the overall therapeutic process. Despite the presence of many drugs for pain therapy on the market, many of them are not approved for use in this group of patients. Knowledge of their mechanisms of action and predicting the impact on metabolism in a pediatric patient compared to an adult is crucial for the management of both acute and chronic pain syndromes. Despite the current knowledge, there is still a need for broader research on the possibility of the drugs used, their impact on the therapy process and side effects in the youngest patients.

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“…Another limitation of the study included the timing of LMX-4 topical numbing cream. While it likely provided pain relief to patients, the length of time the cream was applied for prior to the blood draw was not tracked and was often only placed for a short amount of time versus the recommended time of 30 minutes for venipuncture procedures (Chumpitazi et al, 2022). If the LMX cream had been utilized according to the manufacturer recommendations, there could have been an increased number of patients who had lower distress and coped better due to decreased pain.…”

Section: Limitationsmentioning

confidence: 99%

The Impact of Child Life Intervention on a Clinical Vaccine Trial

Wright

Gerson

Staab

2023

The Journal of Child Life: Psychosocial Theory and Practice

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Needle-related procedures, such as vaccines, can be especially stressful for children. One children’s hospital secured funding to staff a child life specialist to provide support to patients enrolled in a vaccine trial. Data was collected to explore how participants coped through multiple nasal swabs, blood draws, and injections and the impact of providing child life support during a clinical research trial. Children supported by a child life specialist for their vaccine exhibited low distress and utilized coping strategies frequently. Participant retention was higher than expected during the clinical trial. The study findings suggest including child life specialists as part of clinical trial teams in future studies.

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Managing acute pain in children presenting to the emergency department without opioids

Cited by 11 publications

References 97 publications

Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision

Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision

Pain therapy in the pediatric population

The Impact of Child Life Intervention on a Clinical Vaccine Trial

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