Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis
Introduction: Pain management among children following thoracic surgery is an area of significant practice variability. Understanding the risk factors of moderate-to-severe pain intensity will allow for adequate pain relief. The aim of the study was to assess the maximum intensity of pain at rest in...
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/844 |
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| author | Lucyna Tomaszek Dariusz Fenikowski Nina Cież-Piekarczyk Wioletta Mędrzycka-Dąbrowska |
| author_facet | Lucyna Tomaszek Dariusz Fenikowski Nina Cież-Piekarczyk Wioletta Mędrzycka-Dąbrowska |
| author_sort | Lucyna Tomaszek |
| collection | DOAJ |
| description | Introduction: Pain management among children following thoracic surgery is an area of significant practice variability. Understanding the risk factors of moderate-to-severe pain intensity will allow for adequate pain relief. The aim of the study was to assess the maximum intensity of pain at rest in pediatric patients within 24 h of thoracic surgery and to investigate the prevalence and predictors of moderate-to-severe pain. Methods and findings: This is a prospective cohort study of patients in observational and randomized controlled trials following thoracic surgery. A secondary analysis of data was conducted using data collected from 446 patients aged 7–18 years undergoing thoracic surgery. The primary endpoint was maximum pain intensity (Numerical Rating Scale; NRS; range: 0–10) and the secondary endpoint was the prevalence and predictors of moderate-to-severe pain (NRS > 2/10). The median maximum pain in the cohort was 3 [0; 4]. During the immediate postoperative period, 54% of patients reported a maximum NRS > 2/10. The infusion of morphine by an intravenous route (vs. epidural route) was a protective factor against moderate-to-severe pain. Taking into account the findings related to the type of epidural analgesia (vs. intravenous morphine), it was found that only the administration of 0.25% bupivacaine combined with morphine or fentanyl was a protective factor against moderate-to-severe postoperative pain. Patients aged 14–18 years (vs. aged 7–13 years) had an increased risk of reporting pain as moderate-to-severe. Conclusions: The route of analgesic administration, type of multimodal analgesia, and patients’ age predict moderate-to-severe pain in pediatric patients after thoracic surgery. |
| first_indexed | 2024-03-08T03:54:04Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:54:04Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cb2df2c25bfe42308fd505cb9ffa068f2024-02-09T15:16:23ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-0113384410.3390/jcm13030844Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data AnalysisLucyna Tomaszek0Dariusz Fenikowski1Nina Cież-Piekarczyk2Wioletta Mędrzycka-Dąbrowska3Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Anaesthesiology and Intensive Care Nursing, Medical University of Gdansk, Gdans, 7 Debinki Street, 80-211 Gdansk, PolandIntroduction: Pain management among children following thoracic surgery is an area of significant practice variability. Understanding the risk factors of moderate-to-severe pain intensity will allow for adequate pain relief. The aim of the study was to assess the maximum intensity of pain at rest in pediatric patients within 24 h of thoracic surgery and to investigate the prevalence and predictors of moderate-to-severe pain. Methods and findings: This is a prospective cohort study of patients in observational and randomized controlled trials following thoracic surgery. A secondary analysis of data was conducted using data collected from 446 patients aged 7–18 years undergoing thoracic surgery. The primary endpoint was maximum pain intensity (Numerical Rating Scale; NRS; range: 0–10) and the secondary endpoint was the prevalence and predictors of moderate-to-severe pain (NRS > 2/10). The median maximum pain in the cohort was 3 [0; 4]. During the immediate postoperative period, 54% of patients reported a maximum NRS > 2/10. The infusion of morphine by an intravenous route (vs. epidural route) was a protective factor against moderate-to-severe pain. Taking into account the findings related to the type of epidural analgesia (vs. intravenous morphine), it was found that only the administration of 0.25% bupivacaine combined with morphine or fentanyl was a protective factor against moderate-to-severe postoperative pain. Patients aged 14–18 years (vs. aged 7–13 years) had an increased risk of reporting pain as moderate-to-severe. Conclusions: The route of analgesic administration, type of multimodal analgesia, and patients’ age predict moderate-to-severe pain in pediatric patients after thoracic surgery.https://www.mdpi.com/2077-0383/13/3/844multimodal analgesiapostoperative painmoderate-to-severe painroute of administrationpredictors |
| spellingShingle | Lucyna Tomaszek Dariusz Fenikowski Nina Cież-Piekarczyk Wioletta Mędrzycka-Dąbrowska Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis Journal of Clinical Medicine multimodal analgesia postoperative pain moderate-to-severe pain route of administration predictors |
| title | Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis |
| title_full | Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis |
| title_fullStr | Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis |
| title_full_unstemmed | Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis |
| title_short | Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis |
| title_sort | maximum pain at rest in pediatric patients undergoing elective thoracic surgery and the predictors of moderate to severe pain secondary data analysis |
| topic | multimodal analgesia postoperative pain moderate-to-severe pain route of administration predictors |
| url | https://www.mdpi.com/2077-0383/13/3/844 |
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