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首页> 外文期刊>Canadian Journal of Emergency Medicine >Pain management practices surrounding lumbar punctures in children: A survey of Canadian emergency physicians
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Pain management practices surrounding lumbar punctures in children: A survey of Canadian emergency physicians

机译：围绕儿童腰椎穿刺的疼痛管理实践：对加拿大急诊医生的一项调查

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ObjectivesLumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.MethodsWe surveyed physicians in the Pediatric Emergency Research Canada (PERC) or Canadian Association of Emergency Physicians (CAEP) databases from May 1 to August 1, 2016, regarding hypothetical scenarios for a 3-week-old infant, a 3-year-old child, and a 16-year-old child requiring an LP. The primary outcome was the willingness to provide analgesia. Secondary outcomes included the type of analgesia, reasons for withholding analgesia, and their perceived competence performing LPs.ResultsFor a 3-week old infant, 123/144 (85.4%) pediatric EPs and 231/262 (88.2%) general EPs reported a willingness to provide analgesia. In contrast, the willingness to provide analgesia was almost universal for a 16-year-old (144/144 [100%] of pediatric EPs and 261/262 [99.6%] of general EPs) and a 3-year-old (142/144 [98.6%] of pediatric EPs and 256/262 [97.7%] of general EPs). For an infant, the most common barrier cited by pediatric EPs was the perception that it produced additional discomfort (13/21, 61.9%). The same reason was cited by general EPs (12/31, 38.7%), along with unfamiliarity surrounding analgesic options (13/31, 41.9%).ConclusionCompared to a preschool child and adolescent, the willingness to provide analgesia for an LP in a young infant is suboptimal among pediatric and general EPs. Misconceptions and the lack of awareness of analgesic options should be targets for practice-changing strategies.
机译：目的腰椎穿刺术（LPs）会使儿童痛苦，并且学术界推荐使用镇痛剂。但是，不到三分之一的儿科急诊医师（EPs）遵守建议。我们评估了在小儿和普通EP中提供镇痛的意愿，并探讨了患者和医护人员的特定障碍。方法我们从5月1日至8月1日在加拿大儿科急诊研究（PERC）或加拿大急诊医师协会（CAEP）数据库中对医生进行了调查。 2016年，关于需要LP的3周龄婴儿，3岁儿童和16岁儿童的假设情景。主要结局是愿意提供镇痛药。次要结果包括镇痛的类型，停止镇痛的原因及其感知的表现能力LP。结果对于3周大的婴儿，有123/144（85.4％）的儿科EP和231/262（88.2％）的一般EP表示愿意。提供镇痛作用。相比之下，对于16岁（144/144 [100％]的儿科EP和261/262 [99.6％]的普通EP）和3岁（142岁）的人来说，提供镇痛的意愿几乎是普遍的/ 144（98.6％）的小儿EP和256/262 [97.7％]的一般EP）。对于婴儿，小儿EP所引用的最常见障碍是对其产生额外不适感的看法（13 / 21，61.9％）。一般的EP指出了相同的原因（12/31，38.7％），以及对止痛药选择的不熟悉（13/31，41.9％）。结论与学龄前儿童和青少年相比，愿意为LP镇痛的人提供镇痛作用。小儿在小儿和普通EP中次优。误解和对止痛药认识不足应成为改变治疗策略的目标。

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