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Retrospective evaluation of pain assessment and treatment for acute vasoocclusive episodes in children with sickle cell disease
Author(s) -
Zempsky William T.,
Loiselle Kristin A.,
McKay Kathleen,
Blake Gabriella L.,
Hagstrom J. Nathan,
Schechter Neil L.,
Kain Zeev N.
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21572
Subject(s) - medicine , opiate , dosing , disease , retrospective cohort study , medical record , pediatrics , acute chest syndrome , emergency department , acute pain , sickle cell anemia , anesthesia , receptor , psychiatry
Background This study was conducted to assess the care of pediatric patients hospitalized for sickle cell disease‐related vasoocclusive episodes (VOE). The aim of this research was to illustrate the course of pain scores and methods of therapeutic intervention during hospitalization. Procedure Retrospective medical chart reviews were conducted to collect pain assessment and management data about children hospitalized during a 2‐year period at an urban children's hospital. T tests and Chi‐square analyses were used to identify differences in demographic variables, pain scores and opiate utilization. Results There were 59 children with 134 hospitalizations for VOE in a 2‐year period. 50.8% of the patients were male; the mean age was 11.5 ± 4.9 years. The average length of hospitalization was 4.6 ± 2.7 days (range 1–19 days). Older patients stayed in the hospital significantly longer than younger patients ( P = 0.002). Pain scores remained in the moderate to severe range (≥5 out of 10) for many days in the majority of patients. Results failed to reveal significant differences in pain scores and opiate utilization between patients who had short versus extended hospitalizations, and for those patients with frequent versus infrequent hospitalizations for pain. Conclusions Despite opiate dosing within recommended guidelines, mean pain scores remain in the moderate to severe range for several days following hospitalization for VOE. Future research should explore the factors which influence pain scores, as well as improved pain assessment and management techniques. Pediatr Blood Cancer 2008;51:265–268. © 2008 Wiley‐Liss, Inc.