[Organization of pediatric pain management: Austrian interdisciplinary recommendations for pediatric perioperative pain management]

Abstract

Background: Postoperative pain management is still in need of vast improvement, especially for children. The aim of this article is to demonstrate which structures and processes must be optimized to ultimately improve patient satisfaction and safety.

Responsibilities: Basic prerequisites are among others personnel continuity and good cooperation in a multiprofessional team. A clear assignment of responsibilities is also of essential importance.

Patient history and informed consent: On admission every patient should be questioned on the currently existing pain. Patients or the parents must be informed about the pain therapy in a comprehensible manner. Possible complications, chances of success, advantages and disadvantages of the planned procedure and alternative forms of treatment must be discussed.

Implementation: The implementation needs a great deal of consideration. The introduction of clearly defined pathways and thorough schooling contribute more to successful pain management than the establishment of pain measurement or the use of special techniques alone.

Evaluation and documentation: Because pain intensity can only be described indirectly it is difficult to assess in children. Assessment is made by another person until children are 5 years old. The gold standard in pain measurement is, however, self-estimation using appropriate scales which is possible for older children. The routinely carried out representation of pain values and prompt documentation of all pain therapeutic measures are indispensible for the control and optimization of pain therapy.

Quality of results: Whether improvements in acute pediatric pain therapy will actually be achieved can only be realized by standardized compilation and analysis of the quality of therapy. For this purpose QUIPSInfant was developed.