Error traps in the perioperative care of children with chronic pain

Genevieve D'souza1, Anureet Walia2, Rita Agarwal1

  • 1Department of Anesthesiology, Perioperative Medicine, and Pain Management, Stanford University School of Medicine, Stanford, California, USA.

Paediatric Anaesthesia
|February 14, 2023
PubMed

Insights

Perioperative care for pediatric patients with chronic pain requires careful planning. Avoiding common errors in pain management, preparation, and multidisciplinary care improves outcomes and patient satisfaction.

Area of Science:

  • Anesthesiology
  • Pediatric Pain Management
  • Healthcare Quality Improvement

Background:

  • Pediatric patients with chronic pain present complex perioperative challenges.
  • Gaps in knowledge and cognitive errors can lead to adverse events, termed error traps.
  • Optimizing perioperative care is crucial for this vulnerable population.

Purpose of the Study:

  • To identify common error traps in the perioperative care of pediatric patients with chronic pain.
  • To highlight strategies for avoiding these errors to improve patient outcomes.
  • To emphasize the role of multidisciplinary and multimodal approaches in pain management.

Main Methods:

  • Review of common errors in perioperative pain management for pediatric patients with chronic pain.
  • Analysis of contributing factors, including knowledge gaps and cognitive errors.
  • Discussion of best practices for perioperative pain management.

Main Results:

  • Common errors include inadequate patient/family preparation, failure to integrate past pain history, insufficient multimodal analgesia, and lack of multidisciplinary involvement.
  • Cognitive errors contribute significantly to these preventable mistakes.
  • Addressing these issues can enhance care quality.

Conclusions:

  • Recognizing and mitigating perioperative error traps is essential for optimizing pain care in pediatric patients with chronic pain.
  • A comprehensive, multidisciplinary approach incorporating mental health and physical therapy is vital.
  • Improved perioperative pain management leads to better patient outcomes and satisfaction.

Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
705
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
367
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
816
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
261
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
21
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
16