Procedural pain in children: education and management. The approach of an Italian pediatric pain center.
Eur J Pediatr
; 171(8): 1175-83, 2012 Aug.
Article
en En
| MEDLINE
| ID: mdl-22395564
ABSTRACT
Pain management should be warranted for all children in every situation. Italian legislation proposes a model for pain assistance based on specialized tertiary centers which provide direct clinical management for complex cases and assure continuous cooperation with hospitals and family pediatricians for managing painful conditions every day. The Procedural Pain Service of the University of Padua Department of Pediatrics applies such model for procedural pain management. We describe activities of Service since January 1, 2006 on two levels education and training for territorial services and sedation-analgesia when required for invasive and painful procedures. Since 2006 to date, the Service team produced an internal protocol for procedural sedation, developed two master courses, and organized a training program for procedural pain management in the territorial context. Procedural sedation-analgesia service provided overall 10,832 sedations to perform 14,264 procedures for 3,815 patients, median age of 6 years old. The most frequently performed procedures were lumbar puncture and bone marrow aspiration, followed by gastroscopy and bronchoscopy. Most frequently administered drug combinations were local analgesia + intravenous midazolam alone or midazolam and propofol or midazolam and propofol and ketamine; most frequently used non-pharmacological methods were distraction using cartoons and bubbles. Minor adverse events were recorded in 281 cases (2.5%), the most common being desaturation (2.1%). In conclusion, our model functions on two integrated levels, and it can be considered generally applicable as a solution for pain management.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dolor
/
Pediatría
/
Sedación Consciente
/
Clínicas de Dolor
/
Manejo del Dolor
/
Analgesia
Tipo de estudio:
Evaluation_studies
/
Guideline
/
Observational_studies
Límite:
Child
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Pediatr
Año:
2012
Tipo del documento:
Article
País de afiliación:
Italia