ABSTRACT
Introduction: Pain is one of the most recurrent complaints obtainable in paediatric settings especially while carrying out procedures. The emergency section is averytaskingplaceforchildren. Hence itisimportant for health care workers to follow a child focussed or individual methods in their assessment and management of pain and painful procedures.Aim:To determine health workers’ approach towards non-pharmacological management of procedural pain in children at the University of Port Harcourt Teaching Hospital (UPTH). Methods: Thisdescriptive cross-sectional study was carried out between November 2019 and January 2020. A semi-structured questionnaire was used to retrieve information on biodata, knowledge and practice of non -pharmacological management of procedural pain in children. Data was entered into Microsoft Excel spread sheet and analysed using Statistical Package for Social Sciences version 21.Results: Respondents in this study included 25(24.8%) physicians and 61(60.4%) nurses. Forty-four respondents (43.5%) had more than 10 years’ workexperience. Self-development 59 (58.4%) was the most common source of knowledge of paediatric pain management. Fourteen(13.9%) respondents knewthe appropriate time of applying non-pharmacological measures of which distraction was the most common strategy mentioned (n=85, 84.2%) and used (36%). Nurses were significantly more knowledgeable about non-pharmacological methods of pain management in children (p= .000).Conclusion: There are gaps in knowledge and practice of clinicians concerning use of non-pharmacological interventions in the management of procedural pain in children. Development of a standard protocol would be an asset. There is need for necessary tools, and institutional commitment to adequate pain relief for children in our institution
ABSTRACT
Introduction:Whereas advances in perioperative care of children continue to be made with increasing evidence-based practice for postoperative analgesia, inadequate relief of postoperative pain resulting in significant morbidity and mortality is still being reported.Objective:To appraise surgeons' perspectives and practice of paediatric post-operative pain assessment and management at a tertiary health facility in southern Nigeria.Methods: In this cross-sectional survey carried out between September and December 2019, asemi-structured and self-administered questionnaire was distributed to surgeons/trainees in departments/units where paediatric patients undergo both major and minor surgeries. Their perspectives and practice of postoperative pain assessment and management were analysed using SPSS version 20.0.Results:Seventy-nine respondents completed the survey, including 19(24%) consultants, 32(40.5%) senior registrars, and 22(27.9%) junior registrars. Two-third of respondents (n=51, 64.6%) had more than 10 years working experience post-graduation. Involving parents/caregiverso assess postoperative pain was the most common strategy used by respondents (n=69, 87.3%), and most of them (n=67, 84.8%) do not make use of any pain assessment tools. Non-pharmacologic strategies for postoperative pain management were applied/prescribed sometimes (n=20, 25%) or rarely (n=20, 25%). Paracetamol and NSAIDs were the commonest non-opioid analgesics used while pentazocine was the commonly used opioid. Many respondents (n=66, 83.5%) had never prescribed morphine for postoperative analgesia in children. Seventeen percent of respondents do not prescribe postoperative analgesia to newborns.Conclusion:Findings of this study show that the practice in our institution falls short of the recommended multimodal approach to paediatric postoperative pain care.Development of standard protocols and training of providers of postoperative care are recommended.