Ugeskrift for laeger
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Ugeskrift for laeger · Jan 1997
Comparative Study[Postoperative pain in children. A comparison between ratings of children and nurses].
Several predominantly North American studies indicate that postoperative pain experienced by children is underestimated by the nurses, who are in charge of the analgesic treatment of the children's pain. The purpose of this investigation was to examine, in Danish children, the relationship between the children's ratings of their pain and the nurses' ratings of the children's pain. The issue was examined by comparing the pain ratings of 100 children three to 15 years of age following tonsillectomy. ⋯ After analgesics, the children's mean pain score was 17% lower than before analgesics, while the nurses' mean pain scores of the children's pain were 53-58% lower than before analgesics. Consistent with results from foreign studies, this Danish study found that, in general, the nurses underestimated the children's pain. The nurses tended to overestimate the effect of analgesics and tended to modify their pain ratings according to the children's level of activity.
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Ugeskrift for laeger · Jan 1997
[Parents' expectations and evaluation of their children's postoperative pain treatment].
In order to improve postoperative pain management in children, the parents of 31 elective surgical children, three months to 15 years of age, were asked preoperatively about their expectations regarding their children's postoperative pain and pain relief. At 24 hours after surgery, the parents were asked about their perceptions of their children's pain and pain control. The survey indicates that the parents had high expectations of good pain relief. ⋯ Twenty-nine percent (9) of the children experienced severe or unbearable pain or experienced pain for all of the 24 h after surgery. An approach to improve pain management in children could be for the hospital staff to reorganize and to develop an "acute pain service". A pain service may not require new technology, but could instead be based on more effective communication and skill in utilizing the traditional systems.
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Postoperative nausea and vomiting (PONV) is still a problem and is very discomforting for the patients. As surgery done on out-patient basis becomes more frequent, PONV will represent an important factor in the length of recovery room stay, and is in this way an economic problem. Based on the literature from 1985-1995 factors associated with increased risk, prevention and treatment of PONV are discussed in view of the physiological mechanisms. ⋯ It demands an individual evaluation with a careful preoperative visit including planning of both preanaesthetic and anaesthetic agents. Furthermore, a proper anaesthetic treatment of the per- and postoperative course is of high importance. Patients at high risk of PONV should be identified and given prophylactic antiemetics.