title: Analgesia following surgery in children with and without cognitive impairment.
abstract: Both children and adults with cognitive impairment (CI) have historically been excluded from research examining pain. This is unfortunate since patients with CI may be at higher risk for experiencing pain or having their pain undertreated due to the difficulty of pain assessment and communication. There are now several published reports about the general pain experience of both adult and pediatric patients with cognitive impairment. The purpose of this study was to compare the amount and type of pain medication administered in children with and without CI after surgery to ascertain if there were any differences in analgesic administration patterns between these two groups. One hundred and fifty-two children with borderline to profound CI and 138 non impaired (NI) children were recruited to participate. Analgesic administration data include type and amount of opioid, type of non-opioid medication, and prescribed discharge medications. Results of this study show that children with CI undergoing surgery received less opioid in the perioperative period than children without CI. However, children with CI received comparable amounts and types of analgesics in the postoperative period as children without CI.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Doernbecher Children's Hospital, 3181 SW Sam Jackson Park Rd, Mailcode UHS2, Portland, OR 97239, USA Department of Pediatrics, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR 97239, USA Division of Clinical Research: Metabolism, Merck Research Laboratories, Rahway, NJ 07065, USA Department of Anesthesiology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR 72202, USA Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR 72202, USA Olympic Research, Incorporated, Steilacoom, WA 98388, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Koh
authors.forename: Debra
authors.initials: D
authors.lastname: Fanurik
authors.forename: R
authors.initials: R
authors.lastname: Dale Harrison
authors.forename: Michael L
authors.initials: ML
authors.lastname: Schmitz
authors.forename: Dan
authors.initials: D
authors.lastname: Norvell
mesh_terms: D000293:Adolescent; D000698:Analgesia / Q000379:methods / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D010149:Postoperative Pain / Q000188:drug therapy* / Q000523:psychology; D019990:Perioperative Care / Q000379:methods / Q000706:statistics & numerical data*
chemical_list: D000701:Analgesics, Opioid