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Quantification of analgesic use in children with sickle cell disease
Eufemia Jacob1, Christine Miaskowski, Marilyn Savedra
1Department of Hematology/Oncology, Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA. exjacob@texaschildrenshospital.org
Insights
The Medication Quantification Scale (MQS) effectively measured pain medication use in children with sickle cell disease during painful episodes. MQS scores decreased daily, correlating with pain characteristics.
Area of Science:
- Pediatric Hematology
- Pain Management
- Pharmacology
Background:
- Sickle cell disease (SCD) commonly causes acute painful episodes (vaso-occlusive episodes).
- Quantifying analgesic use in hospitalized children with SCD is crucial for effective pain management.
- Existing methods may not fully capture the complexity of analgesic administration in SCD pain.
Purpose of the Study:
- To quantify analgesic use in children hospitalized with SCD for vaso-occlusive episodes using the Medication Quantification Scale (MQS).
- To explore the relationship between pain intensity, pain descriptors, affected body areas, and administered analgesic amounts.
Main Methods:
- Children aged 5–19 years provided daily pain intensity ratings and described pain location and quality.
- Nursing records were reviewed for analgesic doses, routes, and frequency over 24-hour periods.
- The Medication Quantification Scale (MQS) was used to standardize analgesic quantification.
Main Results:
- Admission pain intensity scores averaged 84.0 (Oucher scale).
- Mean MQS scores on admission were 15.7, decreasing significantly each hospitalization day.
- Significant correlations were observed between pain characteristics and MQS scores at admission.
Conclusions:
- The MQS proved to be a sensitive and useful tool for quantifying analgesic use in pediatric SCD patients during acute painful episodes.
- MQS scores effectively accounted for variations in analgesic types, routes, dosing, and opioid requirements.
Objectives:
The purposes of this study were: (1) to quantify analgesic use in children with sickle cell disease who were hospitalized for a vaso-occlusive episode, using the Medication Quantification Scale (MQS) and (2) to examine the relationships between pain intensity scores, number of painful areas marked on a body outline diagram, number of word descriptors of pain quality, and amount of analgesic medications administered.
Methods:
Children (5 to 19 y) were asked daily to provide pain intensity ratings and describe the location and quality of their pain. The nursing flowsheets were also reviewed to determine the dose, routes, and the number of times analgesic medications were administered in the previous 24 hours.
Results:
Mean worst pain intensity score on the day of admission was 84.0+/-9.9 (range 63.8 to 100) on the 0 to 100 Oucher numeric rating scale. The mean MQS score administered on the day of admission was 15.7+/-4.9 (range 6 to 24). This score decreased significantly by 1.2+/-0.5 (P<0.0001; range 0.9 to 2.5) each day of hospitalization. Significant correlations were found between various pain characteristics and total MQS scores prescribed at time of admission.
Discussion:
The MQS was a useful and sensitive measure to quantify analgesic use in patients with sickle cell disease who were hospitalized for an acute painful episode. The MQS score accounted for variations in the types of analgesic medications, routes of administration, dosing schedules, and opioid dosing requirements.
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