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Pharmacy World & Science

, Volume 30, Issue 3, pp 251–257 | Cite as

Comparison of pain management in paediatric surgical patients in two hospitals in France and Canada

  • Sonia Prot-Labarthe
  • Élaine Pelletier
  • Ursula Winterfeld
  • Edith Villeneuve
  • Chantal Wood
  • Jean-François Bussières
  • Françoise Brion
  • Olivier BourdonEmail author
Research Article

Abstract

Objective Pain management in children has improved substantially over the last few years but continues to vary widely across institutions. Our objective was to describe the evaluation and treatment of pain in paediatric patients in two hospitals (Robert Debré in Paris, France, and Sainte-Justine, Montréal, Canada) and to compare conformity with quality criteria. Method Retrospective medical chart of a total of 200 patients with uncomplicated appendectomy, spinal fusion, ureteroneocystostomy, or laparoscopic cholecystectomy were analysed, with special attention to nurses’ entries, prescriptions, and medication administration sheets. Main outcome measure Patient characteristics and variables pertaining to pain evaluation (tool and result) and treatment (date, prescription and administration details) were collected. Quality criteria for evaluating conformity with guidelines were taken from the literature. Any change in medication, dosage, or dosing interval was taken as a new prescription. Results About 929 prescriptions and 2,388 numerical pain scores were recorded for 200 patients. Pain was recorded at 70.8% of vital-sign evaluations at the Robert-Debré Hospital compared to 30.9% at the Sainte-Justine hospital (P < 0.0001). A validated age-appropriate pain evaluation tool was used in 97.4 and 94.1% of evaluations in these two hospitals, respectively (P < 0.0001). Analgesic dosage was appropriate in 92.5% of prescriptions at Robert-Debré and 86.0% of those at Sainte-Justine (P = 0.002). Conclusion This study documents differences in post-operative pain management between two paediatric hospitals. We found differences between the two hospitals regarding the frequency of pain evaluation, the use of validated tools for evaluating pain, and analgesic dosages. Continued efforts to educate prescribing physicians and other healthcare providers are needed to improve pain management in children.

Keywords

Assessment Canada France Pain management Paediatrics Postoperative pain Quality criteria Surgery 

Notes

Acknowledgements

Pascale Bouday, Service du programme de médicalisation des systèmes d’information, RD for providing us with access to the hospital databases; Pascal Bessonneau, for statistic assistance; Sylvie Charrette, RN, Postoperative Analgesia Department, SJ, for validating the study design and sharing her experience in the field; SJ and RD Surgery Department.

Funding Société Française de Pharmacie Clinique and Roche Inc. awarded a grant to Olivier Bourdon in 2004 for this project.

Conflict of interests This project was supported by a grant from the Société Francaise de Pharmacie Clinique and Roche Inc. This has, to our knowledge, not influenced the study, its results, or this article.

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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Sonia Prot-Labarthe
    • 1
  • Élaine Pelletier
    • 1
  • Ursula Winterfeld
    • 2
  • Edith Villeneuve
    • 3
  • Chantal Wood
    • 4
  • Jean-François Bussières
    • 1
  • Françoise Brion
    • 2
  • Olivier Bourdon
    • 2
    Email author
  1. 1.Hôpital Sainte-Justine, Département de pharmacie, Unité de Recherche en Pratique PharmaceutiqueUniversité de MontréalMontréalCanada
  2. 2.AP-HP, Hôpital Robert Debré, Département de pharmacieUniversité Paris DescartesParisFrance
  3. 3.Hôpital Sainte-Justine, Département d’anesthésieClinique de la douleurMontréalCanada
  4. 4.AP-HP, Hôpital Robert DebréUnité d’évaluation et traitement de la douleurParisFrance

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