title: Current practice of acute pain management in children-a national follow-up survey in Germany.
abstract: OBJECTIVE
  This study aimed to summarize the current standard practices for acute pain management in children in Germany and the implementation of these procedures. The last survey on acute pain management in children was performed in 1999, highlighting the need for an up to date review.
  
  
  METHODS
  A questionnaire was mailed to German departments of anesthesiology (n = 885), asking for structures and processes of acute pain management in children. Results were compared between hospitals with and without an acute pain service and with and without a pediatric department.
  
  
  RESULTS
  Of the 407 responding hospitals (response rate of 46%), 342 treated children younger than 14 years. These were considered for analysis. Of the 342 hospitals, 42% contained either a general pediatric department or a department of pediatric surgery, and the majority of the responding hospitals had an acute pain service (83%). Pain intensities were measured at least once per shift in 40% of the institutions, and at least once or twice a day in 27%. Of the institutions, 31% did not document pain scores regularly, without any difference between hospitals with or without a pediatric department. Standard operating procedures for acute pain management existed in 68% of the hospitals, with large differences in content and length. Opioids were administered to children in 85% of the hospitals. Nonopioid analgesics were the first choice baseline analgesics in most hospitals. Peripheral regional and epidural analgesia were performed in children in 18% and 8% of the hospitals, respectively (21%/16% with a paediatric department, 16%/1% without; P < 0.001).
  
  
  CONCLUSIONS
  Current practice of pediatric pain management varied widely and the recommendations of guidelines, like regular pain management, were frequently not met. However, improvements could be observed since 1999, for example, an increase in regular pain measurements (4% vs 67%). Furthermore, pain management in hospitals running a pediatric department had a higher degree of organization, and more sophisticated analgesic techniques.
authors.affiliation: Department of Anaesthesiology, University Medical Centre, Georg August University of Göttingen, Göttingen, Germany.|Section "Acute Pain", German Pain Society, Berlin, Germany.
authors.forename: Miriam I
authors.initials: MI
authors.lastname: Emons
authors.affiliation: Department of Anaesthesiology, University Medical Centre, Georg August University of Göttingen, Göttingen, Germany.|Section "Pain Medicine", German Society of Anaesthesiology and Intensive Care, Nürnberg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Petzke
authors.affiliation: Section "Acute Pain", German Pain Society, Berlin, Germany.|Section "Pain Medicine", German Society of Anaesthesiology and Intensive Care, Nürnberg, Germany.|Department of Anaesthesiology and Pain Medicine, Inselspital and Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Ulrike M
authors.initials: UM
authors.lastname: Stamer
authors.affiliation: Section "Acute Pain", German Pain Society, Berlin, Germany.|Section "Pain Medicine", German Society of Anaesthesiology and Intensive Care, Nürnberg, Germany.|Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Meißner
authors.affiliation: Department of Anaesthesiology, University Medical Centre, Georg August University of Göttingen, Göttingen, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Koschwitz
authors.affiliation: Department of Anaesthesiology, University Medical Centre, Georg August University of Göttingen, Göttingen, Germany.|Section "Acute Pain", German Pain Society, Berlin, Germany.|Section "Pain Medicine", German Society of Anaesthesiology and Intensive Care, Nürnberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Erlenwein
mesh_terms: D059787:Acute Pain / Q000628:therapy*; D000700:Analgesics / Q000627:therapeutic use*; D002648:Child; D005500:Follow-Up Studies; D005858:Germany; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management / Q000379:methods*; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics
keywords: NSAIDs; acute pain; child; opioids; quality improvement; regional