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Pain and anxiety in pediatric burn patients undergoing surgical interventions: A prospective observational study
Indu M Sen1, Deepika Joshi1, Nitika Goel1
1Department of Anaesthesia, PGIMER, Chandigarh, India.
Insights
Pediatric burn patients experience significant pain and anxiety, particularly with high-voltage or deep burns. Surgeries like debridement and skin grafting increase these distress levels, highlighting the need for comprehensive care.
Area of Science:
- Pediatric Surgery
- Burn Management
- Pain and Anxiety Assessment
Background:
- Pediatric burn injuries are traumatic, necessitating a multidisciplinary approach.
- Anesthesiologists are vital for pain relief and anxiety reduction in pediatric burn patients undergoing surgery.
- This study prospectively observed pain and anxiety in children with burns requiring surgical intervention.
Purpose of the Study:
- To evaluate pain and anxiety levels in pediatric patients admitted with burns requiring surgical interventions.
- To identify factors associated with higher pain and anxiety scores in this population.
- To inform strategies for improved perioperative management of pediatric burn patients.
Main Methods:
- Fifty pediatric patients (aged 7-14 years) with burns requiring surgery were enrolled.
- Evaluated perioperative parameters including burn etiology, severity, and total burn surface area.
- Assessed preoperative pain using Numerical Pain Rating Scale (NPRS) and FLACC scale; anxiety using Revised Child Anxiety and Depression Scale (RCADS-25).
Main Results:
- High-voltage and deep partial-thickness burns were associated with significantly higher pain levels.
- Debridement surgeries correlated with high pain scores both pre- and postoperatively.
- Anxiety levels were elevated in children undergoing amputation, debridement, and skin grafting.
Conclusions:
- Pediatric patients with high-voltage electric burns reported higher pain than those with thermal burns.
- Debridement surgeries are linked to significant pain, underscoring the need for effective analgesia.
- Anxiety is notably higher in children undergoing amputation, debridement, and skin grafting, emphasizing psychological support.
Background And Aims:
Paediatric burn injuries are distressing and traumatic experiences for children and their families. Managing these patients requires a multidisciplinary approach, with anesthesiologists playing a crucial role in providing pain relief and reducing anxiety during surgical interventions. This prospective observational study aimed to evaluate pain and anxiety levels in children admitted with burns requiring surgical interventions.
Material And Methods:
Fifty pediatric patients aged 7 to 14 years were enrolled in the study. Perioperative parameters, including a etiology, severity, and total burn surface area involved, were evaluated. Preoperative pain scores were evaluated using the following pain assessment scales: the numerical pain rating scale (NPRS) and revised faces, legs, activity, cry, and consolability (FLACC) scale. Preoperative anxiety was measured using the revised child anxiety and depression scale (RCADS-25). Both the parent and child versions of the RCADS-25 were conducted separately in an understandable language.
Results:
There was a significant association between pain levels and specific types of burn injuries, with high-voltage burns and deep partial-thickness burns being more distressing. Anxiety levels were higher in children undergoing debridement, superficial skin grafting, and amputation compared to other surgical procedures, emphasizing the importance of addressing the psychological well-being of burn patients.
Conclusions:
Significantly higher pain scores were observed in pediatric patients with high-voltage electric burns compared to those with thermal burns. Patients undergoing debridement surgeries reported high pain scores in both the preoperative and postoperative periods. Anxiety scores were significantly higher in patients undergoing amputation, debridement, and skin grafting surgeries.
