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Prevalence of moderate-severe pain in hospitalized children

Cornelius B Groenewald1, Jennifer A Rabbitts, Darrell R Schroeder

  • 1Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.

Paediatric Anaesthesia
|February 16, 2012
PubMed

Insights

The prevalence of moderate-severe pain in hospitalized children is high, affecting 27% of patients. Pain management strategies, including regional anesthesia and non-opioid analgesics, may be underutilized, leading to persistent pain in many pediatric patients.

Area of Science:

  • Pediatric Pain Management
  • Hospital Medicine
  • Pain Prevalence Studies

Background:

  • Acute pain management in pediatric populations is frequently inadequate.
  • The actual prevalence of pain among hospitalized children in the U.S. has not been established.

Purpose of the Study:

  • To determine the prevalence of moderate-to-severe pain in hospitalized pediatric patients.
  • To identify risk factors, analyze analgesia regimens, and assess pain outcomes in this population.

Main Methods:

  • A retrospective review of clinical data for all pediatric admissions at Mayo Eugenio Litta Children's Hospital in July 2009.
  • Identification of patients experiencing moderate-to-severe pain and analysis of their risk factors, treatments, and outcomes.

Main Results:

  • The prevalence of moderate-to-severe in-hospital pain was 27%, with higher rates in teenagers (38%) and infants (32%) compared to other children (17%).
  • Patients on surgical services (44%) had significantly higher pain prevalence than those on medical services (13%). Regional anesthesia was underutilized (7.2%).
  • Opioids were common (scheduled for 36%, PRN for 40%), while non-steroidal anti-inflammatory drugs (NSAIDs) were available for only 21%. Over half of patients experienced moderate-to-severe pain the day after diagnosis, with 13% still experiencing daily pain by day four.

Conclusions:

  • Moderate-to-severe pain is highly prevalent in hospitalized children.
  • Current analgesia regimens may be suboptimal, with potential underuse of regional anesthesia contributing to persistent pain.
  • A significant proportion of pediatric patients experience prolonged, clinically significant pain during hospitalization.
Abstract

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