Effectiveness of postoperative pain therapy in children assessed by their parents – is inadequate analgesia potentially dangerous?

Abstract

Inadequate pain therapy can lead to negative physical and psychological consequences, increase complications and even mortality. We aimed to assess effectiveness of postoperative analgesia in children from their parents’ point of view. We also wanted to evaluate their degree of satisfaction of postoperative analgesia and to identify areas for improvement. Patients’ parents (n = 85) from Paediatric University Hospital in Warsaw, Poland, took part in our survey. They evaluated pain intensity on five-point Likert Scale and on numerical rating scale (NRS). Mean value of pain on NRS was 4.22 (SD±2,53). On Likert scale the majority of parents described pain intensity as moderate. High percentage (38.82%) of children were in pain while their parents took the survey and only 19% of children did not feel pain at all. In 36 children (42.36%) pain caused sleep disturbances. In same cases non-pharmacological methods of analgesia were effective. Due to inadequate pain relief one of the parents arbitrarily administered a formulation containing paracetamol and codeine. The study revealed low efficacy of analgesia among children of surveyed parents. Their level of satisfaction was inadequately high (91% of them were „very satisfied” or “rather satisfied”). The survey confirmed the need for systematic pain assessment tools. Parental education seems necessary to make them aware that postoperative pain can be treated effectively. Administration of drugs without consulting medical staff is dangerous. It may result in the use of contraindicated agents (as in the case described), drug overdose or unexpected interactions.