Analgesia for children with acute abdominal pain: a survey of pediatric emergency physicians and pediatric surgeons. Pediatrics 2003 Nov;112(5):1122-6
Date
11/05/2003Pubmed ID
14595056DOI
10.1542/peds.112.5.1122Scopus ID
2-s2.0-0242300665 (requires institutional sign-in at Scopus site) 48 CitationsAbstract
OBJECTIVE: To evaluate the current opinion and practice of pediatric emergency medicine physicians (PEM) and pediatric surgeons (PS) on the use of opioid analgesia in children with acute abdominal pain during their evaluation in the emergency department.
METHODS: All members of the American Academy of Pediatrics in the Section of Emergency Medicine and the American Pediatric Surgeons Association were mailed a copy of the survey. Inclusion criteria were board-eligible or -certified PEM, or PS certified by American Board of Surgery or Royal College of Surgeons currently in practice whose patient population includes children. Information on primary patient population, years in practice, practice setting, willingness to provide analgesia for acute nontraumatic abdominal pain in children, and the factors influencing their decision were requested. Data were analyzed with the Student t test and chi(2) analysis.
RESULTS: Of 1441 surveys sent, 54 were returned because of incorrect addresses. Of the 1387 presumed received, 702 completed surveys were returned with a response rate of 51%. However, of those who responded, 574 (82%) respondents met our inclusion criteria, and 385 (67%) were PEM and 189 (33%) were PS. Compared with PEM, more PS had >10 years of work experience and were in private practice. More PEM were willing to provide analgesia before definitive diagnosis. However, the overall willingness to provide analgesia was low in both groups. Among the physicians with <10 years of experience, there was no statistical difference between PEM and PS in willingness to provide analgesia. However, among the physicians with >10 years of experience, 61% of PS were less likely to provide analgesia compared with 38% of the PEM (Delta = 23%; 95% confidence interval 13%, 33%). Of the 74 PEM who made optional general comments, 64 (87%) cited disapproval by the PS as the main barrier in providing analgesia.
CONCLUSIONS: The practice of providing analgesia for children with acute abdominal pain is divergent between PEM and PS. More experienced surgeons are less likely to provide analgesia for children with acute abdominal pain. The perceived disapproval of providing analgesia to children with acute abdominal pain by PS is a barrier influencing PEM practice.
Author List
Kim MK, Galustyan S, Sato TT, Bergholte J, Hennes HMAuthor
Thomas Sato MD Emeritus Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Abdominal PainAcute Disease
Analgesia
Analgesics, Opioid
Child
Data Collection
Drug Utilization
Emergency Medicine
General Surgery
Humans
Pediatrics
Physicians
Practice Patterns, Physicians'
