Pain management in children with and without cognitive impairment following spine fusion surgery

Authors: Malviya, Shobha; Voepel-Lewis, Terri; Tait, Alan R.; Merkel, Sandra; Lauer, Anthony; Munro, Hamish; Farley, Frances

Source: Paediatric Anaesthesia, Volume 11, Number 4, July 2001 , pp. 453-458(6)

Publisher: Wiley-Blackwell

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Abstract:

Background: We compared pain assessment and management practices in children with and without cognitive impairment (CI) undergoing spine fusion surgery.

Methods: The medical records of 42 children (19 with CI and 23 without) were reviewed and data related to demographics, surgery, pain assessment and management, and side-effects were recorded.

Results: Fewer children with CI were assessed for pain on postoperative days (POD) 0-4 compared to those without CI (P < 0.002). Self-report was used for 81% of pain assessments in children without CI, while a behavioural tool was used for 75% of assessments in cognitively impaired children. Children with CI received smaller total opioid doses on POD 1-3 compared to those without CI (P ≤ 0.02). Furthermore, children without CI received patient/nurse-controlled analgesia for more postoperative days than children with CI (P=0.02).

Conclusions: Our data demonstrate a discrepancy in pain management practices in children with and without CI following spine fusion.

Keywords: postoperative pain; pain management; pain assessment; cognitive impairment; children

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1460-9592.2001.00686.x

Affiliations: 1: Departments of Anesthesiology and Surgery, University of Michigan Health Systems, Ann Arbor, MI, USA

Publication date: 2001-07-01