Analgesia for procedural pain: Current practice among Nigerian paediatricians

Abstract

Background: Minor procedures such as venepuncture and lumbar puncture among others are routinely performed in the neonatal intensive care units (NICUs) and paediatric wards. These procedures are accompanied by varying degrees of pain which, if not addressed, can lead to undesirable physiological, cardiovascular, respiratory, hormonal, metabolic and behavioural responses. This study evaluated the current strategies for reducing procedural pain in children in Nigeria. Methods: This was a questionnaire-based, cross-sectional random survey of the current practice of analgesic techniques for procedural pain among 240 respondents out of 700 consultant paediatricians and residents who attended the annual Paediatric Association of Nigeria Conference in 2018. Results: The male-to-female ratio was 1:1.3, the mean age of the respondents was 38.28 ± 7.36 years and the median year of practice was 10 years. Of the surveyed respondents, consultants and trainees constituted 40.8% and 59.2%, respectively, whereas 46.2% and 51.3% of them assessed pain and routinely administered analgesia to treat procedural pain, respectively. Breastfeeding and topical analgesic agent were prescribed by 18.3% and 12.9% of the respondents, respectively. Pain of venous access and lumbar puncture were treated by 38.8% and 19.6% of the respondents, respectively. Only 13.3% of the respondents have institutional guidelines for pain assessment and treatment in their practice locations. Conclusion: The survey showed that, even though a sizeable proportion of paediatricians do assess pain and provide some form of analgesia for procedural pain, there is a lack of institutional pain treatment guidelines in most hospitals attending to the medical needs of children in Nigeria.