Pain management interventions in the Paediatric Intensive Care Unit: A scoping review

Nurses’ Perceived Barriers to and Facilitators of Pain Assessment and Management in Critical Care Patients: A Systematic Review

“…Also, a scoping review conducted to explore the issue of pain management in pediatric intensive care units reported poor attitudes among nurses regarding the use of valid nonverbal pain assessment tools. 43 Furthermore, several studies conducted in different countries and settings reported negative attitudes among nurses towards pain assessment and management. 42 Moreover, Devlin et al 11 explored the beliefs of nurses regarding sedation and found the misconception that “sedated patients don’t feel pain at all” to be a major barrier to adequate pain management.…”

Predicting Who Receives Nonpharmacologic Pain Interventions in the Pediatric Intensive Care Unit

“…For example, caregiver presence has been noted to be associated with reduced pain in children during painful procedures and increased likelihood of receiving other nonpharmacologic pain interventions during a painful procedure ( Erdogan et al, 2020 ;McCarthy et al, 2010 ;McNair et al, 2019 ;Rennick et al, 2011 ); however, it is not evident in our findings whether caregiver presence was recorded as a pain intervention whenever a parent was in the room, regardless of the caregiver activity or whether a procedure was being performed. There are several potential reasons for this lack of thoughtfulness when documenting nonpharmacologic pain interventions: shortage of staff and time, lack of trust in efficacy of nonpharmacologic pain interventions, and lack of awareness or education regarding nonpharmacologic pain interventions ( Ismail et al, 2019 ;Manou, 2014 ;Plummer et al, 2017 ;Stewart & Cox-Davenport, 2015 ). Dropdown choices within the EHR may also influence which interventions are recorded.…”

“…Although pharmacologic interventions for pain management have been frequently studied in critically ill children, limitations, including side effects and concerns about opioid misuse, exist ( Fortuna et al, 2010;Gaither et al, 2016;McCabe et al, 2017 ). As a result, there has been interest in providing nonpharmacologic interventions to children in PICUs ( Abela et al, 2020 ;Ismail et al, 2019 ). Nonpharmacologic interventions, including psychological (e.g., distraction), environmental (e.g., decreased environmental stimuli), and physical approaches (e.g., massage), are indicated for pain management in infants and children as they augment the effectiveness of or reduce the need for pharmacologic management ( Friedrichsdorf & Goubert, 2020 ).…”

“…Pharmacologic interventions are studied more often in the PICU than nonpharmacologic approaches. In a recent scoping review of research-based pain management interventions in the PICU, 21 (78%) of the 28 articles reviewed were focused on pharmacologic pain management ( Ismail et al, 2019 ). The fast pace, heterogeneity of the patient population, and ever changing critical nature of care delivery in PICUs may impact attention given to implementing and studying nonpharmacologic pain management techniques in this setting.…”

Comfort-holding in critically ill children: a scoping review

“…[9][10][11] Uncontrolled pain and agitation are associated with both short-and long-term negative sequelae including delirium, anxiety, post-traumatic stress, and chronic pain syndromes. [12][13][14][15][16][17][18][19][20] Currently, pharmacologic interventions are the standard of care to address patients' physical and psychological comfort. 13,19,[21][22][23] Nevertheless, these are associated with negative short-and long-term effects, including neurotoxicity, delirium, prolonged PICU length of stay, and long-term neurocognitive effects for infants and children.…”