A survey of postoperative pediatric pain management among seven hospitals in northeastern Thailand

Abstract

Background: Health professionals often underestimate children’s pain and do not treat it as a priority. To raise awareness,
the International Association for the Study of Pain has launched a campaign “Global Year against Pain in Children” in 2005,
but evidence shows that the pain in children still remains undertreated.
Objective: to determine the prevalence of postoperative pain and the methods for pain treatment in pediatric patients
Methodology: This survey was done on a one-day period in 7 hospitals in northeastern Thailand. Participants were all inpatient
children of the age <15 years old or their parents. Exclusion criteria were newborn and critically ill infants. Interesting
data included; pain prevalence (pain score > 1 during the past 24 hrs), patients’ perception of receiving pain treatment. Self
report pain was measured with the use of either numerical rating scale (0 to 10 scales) or the Faces Pain Scale-Revised (0-5
faces). For those who were unable to self report pain, the Neonatal Infant Pain scale was used. Types of surgery, days after
surgery, prescription for pain relief and non-pharmacological measures used for pain relief were also recorded.
Results: One hundred and thirty three of 487 patients (27.3%) were surgical cases. The prevalence of postoperative pain
during the past 24 hrs was 69.2%, but those who had moderate to severe pain was 43.6%. Most of children (78.2%)
experienced mild or no pain at the time of interview. Almost a half (44.6%) of them perceived they had pain medication
upon request and more than half of them (60.1%) used non-pharmacological methods for supplementary pain relief. Two
most common prescribed medications were paracetamol (51.9%) and morphine (25.6%). The proportion of medication
administered to patients was less than those found in the prescription such as 24.8% vs 51.9% for paracetamol and 8.3% vs
25.6% for IV morphine. Only three conventional routes, oral, intravenous and intramuscular /subcutaneous routes, were
found in the prescription for pain treatment.
Conclusion: Postoperative pain remains undertreated in northeastern Thailand. We need to raise awareness level and
improve the understanding and the knowledge about Postoperative pain and its management.
Keywords: Postoperative pain; Pediatric; Pain management
Citation: Thienthong S, Sriraj W, Siripul P, Finley A, Boonyawattanangkool K, Kasetwetin S. A survey of postoperative
pediatric pain management among seven hospitals in northeastern Thailand. Pain & Intensive Care 2014;18(1):38-42