Assessment of nurses' judgement for analgesic requirements of postoperative children

Over the last 5-10 years, there has been significant growth in the knowledge and strategies of pain management in children. Investigations are required to discern whether concomitant improvements in clinical practice have occurred. The purpose of this study was to identify the nurses' administration of a traditional analgesic (acetaminophen) with regard to appropriate doses and time intervals. This issue was examined, within 24 h after surgery, in 72 children (aged 3-12 years) scheduled for a tonsillectomy. Acetaminophen suppositories were administered in subtherapeutic doses and at too large time intervals. An average single dose administered represented 87% of the calculated dose. Comparison between the correct dose, which should have been given considering the dose levels of the suppositories available, and the actual dose administered indicates that the nurses tended to round doses down to the next lowest. The average dosage administered per day represented only 76% of the recommended dosage. The prevalence of pain amongst the children was high both before and after analgesics, indicating that acetaminophen in the doses used did not provide any significant measure of pain relief. Current practice is still not optimal. Educating nurses on the effective use of traditional pain therapies may improve paediatric pain management.