Educational video to improve the knowledge of health care providers in pain assessment of preschool children.

Objective: To evaluate the effect of pain assessment with preschool children educational video to assist healthcare providers’ ability to assess pain using CHEOPS and FLACC scores. Methods: A randomized controlled study was conducted in healthcare providers having less than one year experience in pediatric pain management. Participants were randomized into study group and control. Participant’s demographic data, existing experience and knowledge in pain assessment, pre-test and post-test’s corrected scores and time required were recorded. Results: One hundred healthcare providers were recruited. There were no differences between groups in pre-test score, the percentage of correct scoring in treatment decision and time required for assessment using CHEOPS and FLACC scores. Improvements in post-test scores were found in both groups with no statistical significance. However, the difference in time needed to compare the pre-post test results was lower in the control group. Twenty nine participants in the study group evaluated the educational video. They stated it to be informative, easy to understand and conveyed confidence about preschool pediatric pain assessment. Conclusion: A pain assessment education video is one of the media that can possibly be used for assisting pain assessment education. It could improve confidence and understanding in healthcare providers treating pain in preschool children.

Time duration to safety sitting in parturient receiving spinal anesthesia for cesarean section with 0.5% Bupivacaine and morphine.

Background: Spinal anesthesia has been used for cesarean section for a long time. However, the proportion of post-cesarean paturients who were able to sit at the fourth hour still remains unclear. Objective: Investigate the proportion of post-cesarean paturients that were able to sit at the fourth hour following spinal anesthesia with 0.5% hyperbaric bupivacaine and morphine. Furthermore, investigate the optimum time to encourage ambulation, and the risk factors delaying time duration to sit. Methods: A prospective observational study was conducted in 240 patients with American Society of Anesthesiologists physical status classification I and II, and single pregnancy parturients undergoing cesarean section. The patients who had body mass index (BMI) >35, estimated blood loss >1000 mL, needed postoperative bed rest, or received postoperative sedation were excluded. Hyperbaric bupivacaine 8-11 mg and morphine 0.2-0.3 mg were used. The patients were evaluated at the fourth hour until they could sit without adverse events or complete the sixth hour. All patients were evaluated for risk factors delaying the time duration to sit. Results: Out of 240 patients, 77.0%, 90.9%, and 98.4% were able to sit at the fourth, fifth, and sixth hour, respectively. The risk factors that delayed time to sit were Bromage scale >1 and pain score >3 by the univariate analysis, and were Bromage scale >1 and pain score >3 by the multivariate analysis. Conclusion: Seventy-seven percent of the patients could sit at the fourth hour, and most patients (98%) could sit at the sixth hour. The risk factors that delayed the time duration to sit were Bromage score >1 and pain score >3.