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The 2002 Lindberg Award. PRN vs regularly scheduled opioid analgesics in pediatric burn patients

D R Patterson1, J T Ptacek, G Carrougher

  • 1University of Washington School of Medicine, Seattle, Washington, USA.

The Journal of Burn Care & Rehabilitation
|November 15, 2002
PubMed

Insights

Treating acute pain in young children, especially for burns, is under-researched. This study found that "as needed" opioid pain relief for pediatric burn patients was similar to regular dosing, suggesting a need for standardized pain management protocols.

Area of Science:

  • Pediatric Pain Management
  • Burn Injury Treatment
  • Pharmacology

Background:

  • Limited research exists on managing acute pain in children under three years old, particularly for burn injuries.
  • Effective pain assessment and treatment strategies for nonverbal pediatric patients remain a challenge.

Purpose of the Study:

  • To prospectively examine pain behavior and opioid analgesic use in pediatric burn patients younger than three years.
  • To compare pain management outcomes between 'as needed' and regularly scheduled opioid analgesic administration in this population.

Main Methods:

  • Prospective monitoring of pain behavior and opioid analgesic intake in 31 pediatric burn patients.
  • Randomized comparison of 'as needed' (pro re nata) versus regularly scheduled opioid analgesics in 12 patients.
  • Observation of pain and medication practices in non-randomized subjects.

Main Results:

  • No significant differences in demonstrable pain were observed between the 'as needed' and regularly scheduled opioid groups.
  • Both groups received equivalent doses of opioid analgesics, indicating 'as needed' dosing was likely administered on a regular schedule.
  • Regularly scheduled opioid analgesics were common practice for most non-randomized subjects.

Conclusions:

  • Current practices suggest a trend towards institutionalized regular opioid administration for pediatric burn patients.
  • Findings offer insights into pediatric opioid dosing and pain measurement for nonverbal subjects.
  • Further research is needed to optimize acute pain management strategies for young children with burns.

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