Acute pain management in children with sickle cell anaemia during emergency admission to a teaching hospital in Lagos, Nigeria

Type Journal Article - South African Journal of Child Health
Title Acute pain management in children with sickle cell anaemia during emergency admission to a teaching hospital in Lagos, Nigeria
Author(s)
Volume 9
Issue 4
Publication (Day/Month/Year) 2015
Page numbers 119-123
URL http://sajch.org.za/index.php/SAJCH/article/download/968/660
Abstract
Background. Optimal pain management in children with sickle cell anaemia (SCA) begins with accurate and thorough pain assessment.
However, little or no evidence of this practice exists among SCA patients in developing countries.
Objectives. To evaluate pain management in children with SCA during emergency admission.
Methods. Children with SCA who were =12 years old, on admission for a painful crisis and who were not using herbal remedies for pain
relief, were prospectively studied at the Lagos University Teaching Hospital (LUTH) over a period of 1 year. A proforma data collection form
was used to obtain information about the demographics of the patients and their parents, as well as pain score, and non-pharmacological
and pharmacological treatments documented in the patients’ case files. Pain was assessed for each patient using the Wong-Baker Faces
Pain Rating Scale.
Results. The median age and weight of the patients were 4 years and 16 kg, respectively. Pain assessment by the physicians was documented
in 10 (8.3%) patients. However, among those assessed for pain by the researchers, 90 (75%) had a moderate pain score of 5 - 8. Fluid therapy
(n=110, 91.7%) and prayers (n=120, 100%) were the most common non-pharmacological therapies administered to the patients while
admitted. Analgesics, either in combinations or as a single medicine, were administered to 100 (83.3%) patients. Paracetamol (n=90, 75%)
and pentazocine (n=80, 66.7%) were the most frequently used analgesics. The dosage of the analgesics prescribed did not conform to the
recommendations of the World Health Organization (WHO).
Conclusion. The SCA children in this study were managed sub-optimally with analgesics. Pain management among this group of children
did not fully conform to the guidelines of the WHO.

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