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首页> 外文期刊>Canadian Journal of Emergency Medicine >Pain management of acute appendicitis in Canadian pediatric emergency departments
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Pain management of acute appendicitis in Canadian pediatric emergency departments

机译：加拿大小儿急诊科对急性阑尾炎的疼痛处理

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Objectives Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). Methods A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital. Data were abstracted using a study-specific, standardized electronic data extraction tool. The primary outcome was the proportion of children who received analgesia while in the emergency department (ED). Secondary outcomes included the proportion of children receiving intravenous (IV) morphine and the timing of analgesic provision. Results A total of 619 health records were abstracted; mean (SD) patient age was 11.4 (3.5) years. Sixty-one percent (381/616) of patients received analgesia in the ED; 42.8% (264/616) received IV morphine. Other analgesic agents provided included oral acetaminophen (23.5% [145/616]) and oral ibuprofen (5.8% [36/616]). The median (IQR) initial dose of IV morphine was 0.06 (0.04, 0.09) mg/kg. The median (IQR) time from triage to the initial dose of analgesia was 196 (101, 309.5) minutes. Forty-three percent (117/269) of children receiving analgesia received the initial dose following surgical consultation; 43.7% (121/277) received their first analgesic after abdominal ultrasound was performed. Conclusions Suboptimal and delayed analgesia remains a significant issue for children with suspected appendicitis in Canadian PEDs. This suggests a role for multidimensional knowledge translation interventions and care protocols to improve timely access to analgesia.
机译：目的怀疑患有阑尾炎的儿童有可能无法进行最佳疼痛治疗。我们试图描述加拿大小儿急诊科（PED）的可疑阑尾炎的疼痛管理模式。方法对加拿大的12个PED进行回顾性病历审查。包括2010年2月或2010年10月因怀疑阑尾炎入院的3至17岁儿童。如果部分评估或在另一家医院接受治疗，则将患者排除在外。使用研究专用的标准化电子数据提取工具提取数据。主要结局是在急诊室接受急诊镇痛的儿童比例。次要结果包括接受静脉注射吗啡的儿童比例和镇痛时间。结果共提取健康记录619条;平均（SD）患者年龄为11.4（3.5）岁。急诊中有61％（381/616）的患者接受了镇痛; 42.8％（264/616）接受了吗啡注射。提供的其他止痛药包括口服对乙酰氨基酚（23.5％[145/616]）和口服布洛芬（5.8％[36/616]）。 IV吗啡的中位数（IQR）初始剂量为0.06（0.04，0.09）mg / kg。从分诊到镇痛初始剂量的中位数（IQR）时间为196（101，309.5）分钟。接受镇痛的儿童中有43％（117/269）在接受外科手术咨询后接受了初始剂量;腹部超声检查后，有43.7％（121/277）的患者首次接受了镇痛。结论对于加拿大PED患者中疑似阑尾炎的儿童，镇痛效果不佳和延迟镇痛仍然是一个重要问题。这表明多维知识翻译干预措施和护理规程对改善及时获得镇痛的作用。

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