A comparison of three scales for measuring pain in children with cognitive impairment

Massaro, Marta; Ronfani, Luca; Ferrara, Giovanna; Badina, Laura; Giorgi, Renata; D'Osualdo, Flavio; Taddio, Andrea; Barbi, Egidio

doi:10.1111/apa.12748

Cited by 29 publications

(34 citation statements)

References 30 publications

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“…These tools may be less reliable in an African setting due to ethnic variation and differences in beliefs. There are no observational tools developed for measuring neuropathic or chronic pain in children [9,32,33]. Self-reporting is considered the most reliable method, especially in the setting of chronic pain [32,34,33].…”

Section: Discussionmentioning

confidence: 99%

“…There are no observational tools developed for measuring neuropathic or chronic pain in children [9,32,33]. Self-reporting is considered the most reliable method, especially in the setting of chronic pain [32,34,33]. But children, especially manijky of those in this cohort, would be too young to selfreport, and those old enough may not be able to self-report for the initial period due to being sedated and/or ventilated [28].…”

Section: Discussionmentioning

confidence: 99%

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The assessment and management of pain in children with Guillain-Barré Syndrome in a sub-Saharan setting.

Hutton

Wilmshurst

2019

JICNA

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Introduction: Neuropathic pain is challenging to manage in children compounded by inappropriate assessment tools. The lack of evidence-based pain control guidelines for children results in clinicians deferring to expert opinion and personal preference. Children with Guillain-Barré Syndrome are particularly at risk is of neuropathic pain. Objectives and Methods: This is a retrospective study of children with Guillain-Barré Syndrome who were admitted to Red Cross War Memorial Children's Hospital, Cape Town, South Africa over a 10 year period. The study reviewed their pain assessment and management practice. Results: Eighty-four children were identified with Guillain-Barré Syndrome. 76% had symptoms of pain and 53% had breakthrough pain reported. Standardised pain rating scales were used in 3 patients. A mean of 2.7 analgesics were used per patient. Carbamazepine and gabapentin, were utilised in 27 and 20 patients respectively. The use of gabapentin increased 73% per annum from 2009. There was no statistical difference between these two groups for length of hospital stay or long-term disability. Conclusion: This study identified a significant gap in the assessment of pain in children with Guillain-Barré Syndrome. Tools to adequately assess pain are needed, especially in immobile and non-verbal children. Management of pain revealed a high use of adjuvant drugs. The dramatic increase in the use of gabapentin related to clinician preference and was not supported by any evidence. Clinical outcomes for both the carbamazepine and the gabapentin group were no different.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The assessment and management of pain in children with Guillain-Barré Syndrome in a sub-Saharan setting.

Hutton

Wilmshurst

2019

JICNA

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“…School-age children and adolescents can usually use verbal scales or visual analog pain scales [29]. As for the assessment of pain for children with cognitive impairment, the Non-communicating Child's Pain Checklist -Postoperative Version is recommended [30,31]. The greater the degree of cognitive impairment, the greater is the likelihood that the child feels less pain.…”

Section: Pain Scalesmentioning

confidence: 99%

Analgesia in the palliative care of children

et al. 2020

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Due to the increasing incidence of terminal illnesses in children, there is great urgency within pediatric medicine to give these patients the best palliative care possible. The main focus of palliative care is to alleviate suffering resulting from the psychophysical condition of the child, which is mostly due to physical pain. The first phase of managing pain in palliative care is quantifying and qualifying pain levels, although this is sometimes difficult to do with pediatric patients. In addition to implementing strategies that alleviate or remove pain for patients, it is also crucial to give patients and their families a feeling of full control over pain. In practice, non-pharmacological and pharmacological methods of analgesia are present. Pharmacological methods include non-opioid and opioid analgesics, followed by co-analgesics as well as methods of regional anesthesia. In order to give these patients the best care possible, it is necessary that the approach be individual, multimodal, multidisciplinary, and considerate of every detail.

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“…When treating pediatric patients, it appears that cognitively impaired children experience pain more significantly in comparison to cognitively intact children. 109,110 Unfortunately, because of their limited verbal communication, pain in children with CI may be undertreated. 111 Therefore, assessment and localization of dental pain is a complicated process when treating these children.…”

Section: Noncommunicative Patients and Challenges In Dental Pain Assementioning

confidence: 99%

Applications of sensory and physiological measurement in oral‐facial dental pain

Dabiri

Harper

Kapila

et al. 2018

Special Care in Dentistry

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Dentists regularly employ a variety of self‐report and sensory techniques to aid in the diagnosis and treatment of tooth‐related disease. Many of these techniques leverage principles borrowed from psychophysics, the quantitative measurement of the relationship between stimuli and evoked sensations, which falls under the larger umbrella of quantitative sensory testing (QST). However, most clinicians fail to meet the bar for what could be considered quantitative sensory testing, and instead focus on qualitative and dichotomous “yes/no” aspects of sensory experience. With our current subjective measurements for pain assessments, diagnosis and treatment of dental pain in young children and individuals (any age) with severe cognitive impairment rely extensively on third‐party observations. Consequently, the limitation of inadequate pain diagnosis can lead to poor pain management. In this review, it discusses mechanisms that underlie acute and chronic dental pain. It details the measurement of somatosensory responses and pulpal blood flow as objective measures of tooth health and pain. It proposes that bridging these varied methodologies will significantly improve diagnosis and treatment of orofacial pain and pathology. It concludes that improving the precision of sensory measurements could yield important improvements in diagnostic challenges in pulpal pathology for noncommunicative and cognitively impaired individuals.

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A comparison of three scales for measuring pain in children with cognitive impairment

Abstract: The NCCPC-PV was the easiest to use for pain assessment in cognitively impaired children and should be adopted in clinical settings.

Cited by 29 publications

References 30 publications

The assessment and management of pain in children with Guillain-Barré Syndrome in a sub-Saharan setting.

The assessment and management of pain in children with Guillain-Barré Syndrome in a sub-Saharan setting.

Analgesia in the palliative care of children

Applications of sensory and physiological measurement in oral‐facial dental pain

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