Pain assessment in children

Brand, Katherine; Court, Colleen A.

doi:10.1016/j.mpaic.2010.02.014

Cited by 9 publications

(10 citation statements)

References 4 publications

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“…The VAS and NRS are well established and effective for self-reported pain in children; however, the complexity of this issue must be addressed, such as previous experience of pain and cultural background 19 20 24 25. VAS for pain assessment can be used in children aged 3 years and older, dependent on the assessment tool used 24. Our study included four children aged 2 years, two receiving INF with VAS scores 0 (three children) and 3 (one child), consistent with the observational behavioural scores.…”

Section: Discussionmentioning

confidence: 99%

Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial

Staubli

Landolt

2019

Emerg Med J

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ObjectiveNitrous oxide 70% (N2O 70%) is an excellent medication for procedural analgosedation (PAS), yet the limit of its analgesic power remains uncertain; therefore, a combination with intranasal fentanyl (INF) was suggested. However, this combination seems to result in a higher rate of vomiting and deeper sedation. This study aimed at assessing the analgesic efficacy, sedation depth and rate of adverse events of PAS with N2O 70% with and without INF.MethodsPatients aged 2–16 years who qualified for PAS with N2O 70% were randomly assigned to receive either INF or placebo prior to N2O inhalation in this randomised, double-blind study, which was performed in a tertiary children’s hospital ED between September 2015 and October 2017. Behaviour during the procedure was evaluated using the Face, Leg, Activity, Cry and Consolability (FLACC) scale and the Modified Behavioural Pain Scale (MBPS); analgesic efficacy was assessed with a self-reported pain scale. Sedation depth using the validated University of Michigan Sedation Scale and adverse events in the ED and during the following 12 hours were documented.ResultsA total of 402 patients were included; 3 did not tolerate N2O and therefore had to be excluded. Overall, 399 patients were analysed, of whom 201 (50.4%) received INF. No significant group differences with regard to FLACC scale score, self-reported pain, MBPS score and sedation depth were found. In addition, the two groups did not differ with regard to all types of adverse events.ConclusionCombining N2O 70% with INF resulted in no differences with regard to FLACC scale score, self-reported pain, MBPS score, patient and parental satisfaction rate, sedation depth, and adverse events.Trial registration numberNCT02533908

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Section: Discussionmentioning

confidence: 99%

Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial

Staubli

Landolt

2019

Emerg Med J

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“…Dentre esses pelas experiências anteriores frente à dor, pela própria cultura e as redes de apoio social. (10)(11)(12) As crianças com déficit cognitivo estão mais vulneráveis à dor, pois apresentam problemas clínicos que podem causar o fenômeno, além da fisiologia relacionada à lesão neurológica. Essas crianças são continuamente expostas a procedimentos dolorosos e pode-se dizer que exibem características comportamentais peculiares, que podem ocultar a expressão de dor.…”

Section: Resultsunclassified

“…Categorias Temáticas Principais aspectos apresentados Características da dor em crianças com déficit cognitivo -Conceito e influências no processo doloroso. (10)(11)(12) -Condições e fatores predisponentes. (13,14) -Comportamentos e particularidades diante da dor .…”

Section: Quadro 1 Distribuição Das Categorias Temáticas Na Análise Dunclassified

“…(10,21,22) -Componentes dos instrumentos de avaliação. (2,8,11,12,14,18,(23)(24)(25) -Escassez de instrumentos validados . (8) Papel do enfermeiro no contexto da avaliação da dor -Cuidado multidisciplinar baseado em evidências.…”

Section: Quadro 1 Distribuição Das Categorias Temáticas Na Análise Dunclassified

“…Pode ser utilizado por qualquer indivíduo que esteja relacionado ao cuidado com a criança. (2,11,12,14,18,22,23) Não foram encontrados estudos que traduziram e validaram o instrumento para a língua portuguesa falada no Brasil.…”

Section: Categoria Temática 1 -Características Da Dor Em Crianças Comunclassified

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Avaliação da dor em crianças e adolescentes com disfunção cognitiva: uma revisão integrativa

Ederli¹,

Tacla²,

Braz³

et al. 2020

Revista Da Sociedade Brasileira De Enfermeiros Pediatras

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Effectiveness of Structured Care Coordination for Children With Medical Complexity

et al. 2023

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ImportanceChildren with medical complexity (CMC) have chronic conditions and high health needs and may experience fragmented care.ObjectiveTo compare the effectiveness of a structured complex care program, Complex Care for Kids Ontario (CCKO), with usual care.Design, Setting, and ParticipantsThis randomized clinical trial used a waitlist variation for randomizing patients from 12 complex care clinics in Ontario, Canada, over 2 years. The study was conducted from December 2016 to June 2021. Participants were identified based on complex care clinic referral and randomly allocated into an intervention group, seen at the next available clinic appointment, or a control group that was placed on a waitlist to receive the intervention after 12 months.InterventionAssignment of a nurse practitioner–pediatrician dyad partnering with families in a structured complex care clinic to provide intensive care coordination and comprehensive plans of care.Main Outcomes and MeasuresCo-primary outcomes, assessed at baseline and at 6, 12, and 24 months postrandomization, were service delivery indicators from the Family Experiences With Coordination of Care that scored (1) coordination of care among health care professionals, (2) coordination of care between health care professionals and families, and (3) utility of care planning tools. Secondary outcomes included child and parent health outcomes and child health care system utilization and cost.ResultsOf 144 participants randomized, 141 had complete health administrative data, and 139 had complete baseline surveys. The median (IQR) age of the participants was 29 months (9-102); 83 (60%) were male. At 12 months, scores for utility of care planning tools improved in the intervention group compared with the waitlist group (adjusted odds ratio, 9.3; 95% CI, 3.9-21.9; P &lt; .001), with no difference between groups for the other 2 co-primary outcomes. There were no group differences for secondary outcomes of child outcomes, parent outcomes, and health care system utilization and cost. At 24 months, when both groups were receiving the intervention, no primary outcome differences were observed. Total health care costs in the second year were lower for the intervention group (median, CAD$17 891; IQR, 6098-61 346; vs CAD$37 524; IQR, 9338-119 547 [US $13 415; IQR, 4572-45 998; vs US $28 136; IQR, 7002-89 637]; P = .01).Conclusions and RelevanceThe CCKO program improved the perceived utility of care planning tools but not other outcomes at 1 year. Extended evaluation periods may be helpful in assessing pediatric complex care interventions.Trial RegistrationClinicalTrials.gov Identifier: NCT02928757

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Pain assessment in children

Cited by 9 publications

References 4 publications

Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial

Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial

Avaliação da dor em crianças e adolescentes com disfunção cognitiva: uma revisão integrativa

Effectiveness of Structured Care Coordination for Children With Medical Complexity

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