Year : 2016 | Volume
: 9 | Issue : 4 | Page : 501--507
Patient-controlled analgesia versus patient-controlled analgesia by proxy for the management of postoperative pain in major pediatric cancer surgery
Essam Mahran, Ahmed H Abou El-Soud, Ahmed S Ragab, Fatma H Elshamy
Department of Anesthesia, ICU, and Pain Therapy department, NCI, Cairo University, Egypt
Children suffer postoperative pain in the same way as adults. Pediatric pain management is a challenge. Patient-controlled analgesia (PCA) is a flexible, reliable, and individualized method in postoperative pain therapy. However, young children are not able to use PCA themselves, and hence they need to receive PCA by proxy (parent or nurse). The guidelines for PCA by proxy in pediatrics are still insufficient.
The aim of this study was to determine the safety and efficacy of PCA by proxy after major pediatric cancer surgery.
Patients and methods
We studied 330 pediatric cancer patients between 1 and 10 years of age scheduled for major surgery. They were divided into three equal groups: group C (child PCA), group P (parent proxy), and group N (nurse proxy). In each group we measured vital signs, pain intensity, total morphine consumption, side effects, and specific PCA monitoring for the first 72 h postoperatively.
We found that pain scores were higher in the nurse group compared with the other two groups on days 2 and 3 (P < 0.001); morphine consumption was higher in the child group (older age). Vital signs were comparable between groups. There were no significant differences in sedation scale, and there were limited complications with no difference between groups.
Parent-controlled PCA is a safe and effective method of analgesia for children between 1 and 6 years of age. Nurse-controlled proxy is safe but not effective in controlling child pain. Child-controlled analgesia is safe and effective in children above 6 years of age.
Anaesthesia, ICU, and Pain Therapy Department, National Cancer Institute, Cairo University, 87th Elmanial Street, El-Manial, Cairo
|How to cite this article:|
Mahran E, Abou El-Soud AH, Ragab AS, Elshamy FH. Patient-controlled analgesia versus patient-controlled analgesia by proxy for the management of postoperative pain in major pediatric cancer surgery.Ain-Shams J Anaesthesiol 2016;9:501-507
|How to cite this URL:|
Mahran E, Abou El-Soud AH, Ragab AS, Elshamy FH. Patient-controlled analgesia versus patient-controlled analgesia by proxy for the management of postoperative pain in major pediatric cancer surgery. Ain-Shams J Anaesthesiol [serial online] 2016 [cited 2017 Oct 22 ];9:501-507
Available from: http://www.asja.eg.net/article.asp?issn=1687-7934;year=2016;volume=9;issue=4;spage=501;epage=507;aulast=Mahran;type=0