Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample

Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample

Post-operative pain management in children and adolescents is critical to successful recovery and enhancing patient experience. Adequate pain therapy cannot be ignored because access to pain management is perceived as a fundamental patient right. However, pediatric patients often experience inadequate pain management, a severe concern for pediatric nurses at the center of patient care (Vittinghoff et al., 2019). Over the past two decades, efforts to address perioperative pain management of pediatric patients have increased, but many children still experience perioperative pain. Pediatric anesthesia varies across states and hospitals or surgical centers due to differences in regulations and financial resources. Nonetheless, it is critical to develop minimal standards for pediatric pain management that children and adolescents should expect after a surgical procedure in any setting, even those with limited resources.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Developing age-specific pain assessment tools and an improved understanding of analgesics in children has been integral in improving pain assessment and management among pediatric patients in the past two decades. The primary barrier remains the misconception concerning pain control. Such misconceptions include perspectives that children do not experience and perceive pain like adults do. Some parents and providers believe analgesics are linked to increased childhood toxicity (Vittinghoff et al., 2019). It is an issue for pediatric nurses because they have to curb these misconceptions and ensure their patients receive the best care and patient experience. Pediatric nurses need an in-depth understanding of the evaluation techniques and therapeutic interventions used for post-operative analgesia to play a critical role in managing post-operative pain in children and adolescents.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Critique of Literature

There is growing research into pediatric post-surgical care, including pain management. Studies recognize the need for increased utilization of pain management strategies in pediatric care to enhance patient experience and generate optimal patient outcomes. According to Gai et al. (2020), providers often underate and under-recognize pain in pediatric populations, leading to inadequate treatment. The research recommends educating and training healthcare practitioners to impact pain management in children positively. The study offers a practical guide to acute pain management in the inpatient pediatric population. It presents valuable modalities for institutions providing pediatric acute pain management, helping them provide safe and effective pain treatment in children.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Gai et al. (2020) posit that multidisciplinary models facilitate effective pain management, emphasizing patient-centered care. The article based its investigations on World Health Organization analgesic ladder, seeking to build on them and develop a modern pain management technique. The updated WHO ladder offers five recommendations to help pediatric practitioners correctly use analgesics, including using oral medications whenever possible, giving analgesics at regular intervals, administering analgesics per pain severity utilizing a pain intensity scale, tailoring medication dosing to individual patients, and maintaining attention to detail throughout pain medication prescription.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Alsharari et al. (2023) explore post-operative pain management in pediatric patients undergoing laparoscopic appendectomy. Per the research, most children undergoing laparoscopic appendectomy (LA) experience severe post-operative discomfort because of peritoneal inflammation and infection. The study aimed to explore post-operative pain (POP) effects in children after LA. Most children undergoing PA instead of open appendectomy would benefit from a multimodal analgesic approach, an efficient and optimal approach for surgical procedures like UGBRSB, UGQLB, and UGTAP. The research also found dexmedetomidine as an effective adjuvant to bolster local anesthetic effects.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Dezfouli and Khosravi (2020) acknowledge pain as a significant concern among ill children because it is associated with high morbidity and mortality rates. Evaluating pain among children is challenging because they experience difficulties verbalizing. The article quotes inadequate clinical information, limited pediatric research, and concerns over opioid side effects as limitations to adequate pain treatment. There are multiple pharmacological and non-pharmacological interventions for pain treatment in management, and the study seeks to offer a detailed description of the pain mechanism, assessment, and management. The study offers valuable insights into suitable pharmacological and non-pharmacological pain treatment and management therapies. The researcher recommends combining pharmacological and non-pharmacological interventions, including non-opioid pharmacologics like NSAIDS and adjuvants, music therapy, massage, and mindfulness, to increase the effectiveness of pain management in children.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

According to Wondemagegnehu and Tadess (2022), pediatric patients remain undertreated for post-operative pain despite improvements in pain management. Data about post-operative pain management in children remains inadequate and limited globally. The study explores post-operative pain management practice in children below five years. The study found that pediatric patients suffer post-operative pain due to ineffective pain assessment and insufficient analgesic medication administration. The findings also show that one analgesic medication was utilized in 67.1% of the patients. About 64.4% of patients received analgesic medications, implying insufficient analgesic medication administration.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Walker (2019) provides recent data on post-operative analgesia safety and efficacy in pediatric patients and how the data influences clinical practice recommendations. The study recognizes that post-operative pain remains a health concern for hospitalized children after being discharged from short stays or ambulatory surgery. The study offers updated recommendations for post-tonsillectomy analgesia, excluding codeine, and suggests regular paracetamol and NSAID administration. The study also addresses the increasing incidence of opioid-related respiratory depression/over-sedation among children and recommends factors, like high-risk groups, to be targeted to reduce the severe or permanent harm. The study suggests increasing procedure-specific evidence to inform technique selection and discussions regarding efficacy and safety with patients, families, or caregivers.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Implications

The studies acknowledge that children suffer from post-operative pain due to inadequate treatment techniques and data to support optimal and safe pain management and treatment. Pediatric providers can benefit significantly from these evidence-supported strategies, techniques, guidelines, and modalities that can effectively manage post-operative pain in pediatric patients. Providers should also use the data to inform education and training needs on how best to provide post-operative care and engage children who experience difficulties verbalizing needs. Generally, the evidence provided is critical in promoting evidence-based practice in pediatric post-operative pain management.(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

References

Alsharari, A. F., Alshammari, F. F., Salihu, D., & Alruwaili, M. M. (2023). Post-operative pain management in children undergoing Laparoscopic appendectomy: A scoping review. Healthcare, 11(6), 870. https://doi.org/10.3390/healthcare11060870(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

‌Dezfouli, S. M. M., & Khosravi, S. (2020). Pain in child patients: A review on management. European Journal of translational myology, 30(2), 8712. https://doi.org/10.4081/ejtm.2019.8712(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Gai, N., Naser, B., Hanley, J., Peliowski, A., Hayes, J., & Aoyama, K. (2020). A practical guide to acute pain management in children. Journal of Anesthesia, 34(3), 421–433. https://doi.org/10.1007/s00540-020-02767-x

Vittinghoff, M., Lönnqvist, P.-A., Mossetti, V., Heschl, S., Simic, D., Colovic, V., Dmytriiev, D., Hölzle, M., Zielinska, M., Kubica-Cielinska, A., Lorraine-Lichtenstein, E., Budić, I., Karisik, M., Maria, B. D. J., Smedile, F., & Morton, N. S. (2019). Post-operative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). Pediatric Anesthesia, 28(6), 493–506. https://doi.org/10.1111/pan.13373(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

Walker S. M. (2019). Pain after surgery in children: clinical recommendations. Current opinion in anaesthesiology, 28(5), 570–576. https://doi.org/10.1097/ACO.0000000000000227

Wondemagegnehu, B. D., & Tadess, M. M. (2022). Practice of Post-operative Pain Management in Under-Five Children in A Tertiary Hospital: A Prospective Crossectional Study. Ethiopian Journal of health sciences, 32(6), 1117–1122. https://doi.org/10.4314/ejhs.v32i6.8(Critical Analysis of Post-Operative Pain Management in Pediatrics-A Comprehensive Nursing Paper Sample)

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