How to measure the child after an operation pain?
the study is published in ‘ annals of Pediatrics ’.
it is difficult to know the degree of suffering of a child that still does not speak after a surgical intervention. Researchers at the Hospital Universitario La Paz (Madrid) have validated the scale ‘ tears ’, the first and only tool in Castilian that measures the inconvenience of minors of fast and simple.
Spain, 2011-April the lack of appropriate tools prevents medical personnel know if children in pre-verbal age, who cannot talk to tell us how much it hurts the surgical wound, is treated appropriately ”, tells SINC Francisco Reinoso, lead author of the study and section chief of Pediatric anesthesia of Hospital Universitario La Paz (Madrid).
in order to alleviate this shortage, the researchers have been validated the first and only Spanish-language scale for measuring pain in children under the age of three years. With this tool, called ‘ tears ’ (an acronym for crying, attitude, normorrespiración, postural tone and facial observation), toilets can identify children who have pain acute after an operation, in which intensity is suffering and check whether the used treatment is effective.
to date, had measured pain in children who spoke and responded to the same scales used in adults. there are some studies conducted with younger children, but with instruments Anglo-Saxon, not always validated in Spanish, as the CHEOPS scale ”, points Reinoso.
the work, published in annals of Pediatrics, was carried out in 54 children aged between one month and six Рafter that age, children know to explain the inconvenience faced by Рthat had been surgically operated in Hospital Universitario La Paz and who were in the unit of recovery Posanest̩sica.
health three – a pediatric anesthesiologist, a resident and a nurse – they were responsible for observing children and measured its rate of crying, psychological attitude, breathing pattern, motor tone and facial expression. The registration was carried out before and after providing postoperative analgesic treatment, which coincides with the moments of greater and lesser pain.
results in 20 seconds.
experts scored simultaneously two types of scores: crying and CHEOPS. To ensure that the records were independent, used three leaves, so that no observer could see scores of others. The results show that the correlation between the scales is very significant.
the main novelty of tears lies in that for the first time the Spanish-speaking workforce that attends to children under six years can use a simple, concise and accurate scale that allows you to assess pain without searching translations from Anglo-Saxon scales, whose concepts are not always conveniently adapted ”, ensures Reinoso.
also allows you to enter factors associated with clinical methodology local. for example, Spanish nurses prefer to measure the rate of breathing through observation rather than measure the heart rate by monitoring, such as the Anglo-Saxon ”, added the doctor.
among the advantages of this scale is that you don’t have any electronic device for the collection of data. Measurement does not disturb the patient and only lasts between 20 and 40 seconds.
However, the authors also point limitations, as the influence of other factors in acute postoperative pain. Cold, hunger, the strange environment and pharmacological interactions can cause agitation after anesthesia general.
the scale is not effective against chronic pain and its application in patients with lung disease or cerebral palsy is complicated. Despite these limitations, crying has been applied to more than 35,000 children in Hospital Universitario La Paz, and this study confirms his reliability.
