Zhonghua Shao Shang Za Zhi. 2021 Mar 3;37(3):1-6. doi: 10.3760/cma.j.cn501120-20200210-00048. Online ahead of print.
ABSTRACT
Objective: To explore the effects of stepwise acute pain management on acute pain and post-traumatic stress disorder (PTSD) in burn children. Method: From November 2018 to December 2019, 196 burn children who were admitted to the Department of Burns of West China Hospital of Sichuan University and met the inclusion criteria were enrolled in the prospective randomized controlled study. The patients were divided into traditional pain management group (97 patients, 51 males and 46 females, aged 1 to 6 years) and stepped pain management group (96 patients, 55 males and 41 females, aged 1 to 6 years) according to the random number table. Children in traditional pain management group were treated with traditional acute pain care, while the children in stepped pain management group were treated with stepped acute pain management (moderate pain was treated with oral administration of acetaminophen sustained-release dry suspension, and severe pain was treated with morphine intravenous injection) after admission. The revised COMFORT behavior scale was applied to compare the resting pain levels of children in the two groups within 3 days after burn (1, 9, and 17 o’clock per day).The adverse reactions of patients in the stepped pain management group during the treatment period were recorded. The occurrence of PTSD one month after injury was evaluated in both groups by the PTSD alternative algorithm. Data were statistically analyzed with independent sample t test, Bonferroni correction, analysis of variance for repeated measurement, chi-square test, Wilcoxon rank sum test, and Fisher’s exact probability test. Results: The pain scores of children in stepped pain management group were lower than traditional pain management group at 1, 9, and 17 o’clock on post injury day (PID) 1, 1, 9, and 17 o’clock on PID 2, and 1, 9, and 17 o’clock on PID 3 (t=2.71, 3.44, 4.05, 4.18, 4.08, 4.19, 4.25, 3.69, 3.71, P＜0.05 or P＜0.01). The pain scores of children in both groups showed a decreasing trend over time. Of the 96 children in stepped pain management group, 84 children were treated with oral administration of acetaminophen sustained-release dry suspension, and 12 children were treated with morphine intravenous injection. No adverse reactions occurred during the treatment period. The incidence of PTSD of children in stepped pain management group was 3.12% (3/96), which was significantly lower than 14.43% (14/97) in traditional pain management group, P＜0.05. Conclusions: The stepped acute pain management can relieve the acute pain and reduce the incidence of PTSD in burn children.
PMID:33706428 | DOI:10.3760/cma.j.cn501120-20200210-00048
