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 Vol. 21 No. 3, March 2009
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AAP Grand Rounds 21:32 (2009)
© 2009 American Academy of Pediatrics

BIOETHICS

Parent or Nurse-Controlled Analgesia for Pain Control in Developmentally Delayed Children

Source: Czarnecki ML, Ferrise AS, Jastrowski Mano KE, et al. Parent/nurse-controlled analgesia for children with developmental delay. Clin J Pain. 2008;24(9):817–824; doi: 10.1097/AJP.0b013e3181773b69[Medline]

The first 20% of the full text of this article appears below.


PICO

Question: Among children with developmental delay, is parent- or nurse-controlled analgesia effective and practical in managing pain?

Question type: Therapy

Study design: Retrospective chart review

 

Investigators from three Wisconsin hospitals collaborated to conduct a retrospective chart review to evaluate the effectiveness of parent/nurse-controlled analgesia (PNCA) in children unable to independently use patient-controlled analgesia (PCA) because of developmental delay.

With PNCA, either a nurse or parent administers a predetermined intravenous dose of opioid analgesia using a PCA pump when they feel the patient is experiencing substantial pain.

The medical records of patients 0–19 years old with developmental delay who had both received PNCA between 1999 and 2004 and monitored pain using the Neonatal Infant Pain Scale (NIPS), a behavioral pain scale with scores ranging from 0–7,1 were reviewed.

Data were collected for 72 hours or until PNCA was discontinued. Mean pain scores as well as dose, rate, and toxicity of analgesia were assessed. Toxicity of opioid analgesia was assessed by identifying supplemental oxygen . . . [Full Text of this Article]

Ferdinand D. (Nick) Yates, MD, MA, FAAP
Private practice, Buffalo, NY