Pediatric pain service in Srinagarind Hospital

Abstract

Abstract

Background: Compared to adults, pain in children is under-treated; however, the need to improve pain service to the pediatric population is receiving greater attention.  We retrospectively reviewed our pain service for children in our hospital in order to ascertain the current service and to improve it where inadequate.

Objective: To study the characteristics of pediatric pain service in Srinagarind Hospital.

Design: Retrospective descriptive study.

Subjects: Pediatric patients receiving pain service from the Department of Anesthesiology between September 2002 and August 2003.

Method: We reviewed medical records of the patients.  Outcome measurements including age, sex, admission ward, pain type, pain treatment, pain assessment, result of treatment, complications and problems occurring during service were recorded.  The results were analyzed using descriptive statistics and presented as means and percentages.

Results: Service was rendered 42 times for 39 patients; 21 of whom were male.  The children averaged 7.14 ± 4.83 years of age.  Twenty six patients (66%) were from the Pediatric Ward, 8 (12.8%) from the Surgical Ward and 5 (12.8%) from Orthopedic Ward.  Seventy-nine and 21% of the services provided were for acute and chronic pain management, respectively.  The most common drug used was opioids (fentanyl).  The technique used for acute pain management was continuous infusion, PCA or intermittent injection.  By comparison, chronic pain was managed using a combination of methods.  Most pain assessment (54.76%) was observation by nurses.  Complications from pain management occurred in 9.5% of cases, mostly nausea and vomiting or sedation, which were successfully controlled.  Pain control was considered satisfactory in 90.5% of the patients.  Four patients (9.5%) died due to disease progression.  The shortage of opioids was the greatest problem we encountered.

Conclusion: Pediatric pain service at Srinagarind Hospital was established in September 2002.  Over the one-year study, 39 patients were served, most for acute pain.  The duration of service was usually between 1 and 3 days.  Fentanyl was the most commonly used medication.  We encountered no serious complications from pain management.

Keywords: Pain Service; Pediatric