Underestimating Children's Self-reported Pain: Agree/Disagree?

Area of Science:

• Pediatric Anesthesiology
• Pain Management
• Surgical Outcomes

Background:

• Accurate postoperative pain assessment in children is crucial for effective management.
• Discrepancies in pain reporting can occur between patients, parents, and healthcare providers.
• The visual analogue scale (VAS) and numeric rating scale (NRS) are commonly used pain assessment tools.

Purpose of the Study:

• To compare postoperative pain scores in children across different surgical types and grades.
• To evaluate the agreement between patient, parent, and nurse pain assessments using VAS and NRS.
• To identify potential differences in pain perception and reporting among these groups.

Main Methods:

• A prospective, randomized study included 172 children aged 7-18 years undergoing elective surgery.
• Pain was assessed 2 hours postoperatively using VAS and NRS by the patient, parent, and nurse.
• Data were analyzed for agreement using intraclass correlation coefficients (ICC).

Main Results:

• Excellent agreement was found between child and parent pain ratings (ICC > 0.90 for both VAS and NRS).
• Good agreement was observed between child and nurse pain ratings (ICC > 0.84 for both VAS and NRS).
• Fathers demonstrated a better ability to predict their child's pain compared to mothers.

Conclusions:

• Parental pain assessments using VAS and NRS closely mirrored children's self-reported pain.
• Nurses tended to underestimate children's postoperative pain when using both VAS and NRS.
• Self-reported pain remains the gold standard, with parental reports serving as a reliable proxy.