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S279 PREVALENCE OF PROLONGED PAIN IN NEONATES
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POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
Methods: 208 school children in age 10–17 years old were examined. It was used objective examination and riskfactors questionnaire for person with LBP (Povoroznyuk V.V., Dzerovych N.I., 2003). Results: 21.3% school children had complaints in LBP (19% – boys, 23% – girls). The age-related peak of symptom was in 14–15 years among girls, at 14 and 16 years among boys (22.2% and 27.7% correspondingly). The localization of the pain was in lumber region in 45.5% children, and combination of lumber and thoracic or cervical pain in 25.5%. The mild pain intensity was in 30.8% girls and moderate – in 26.9% girls and 55.6% boys. 62% children had pain in day-time with duration not more than 30 min. LBP was increasing with heavy load lifting or during continuous bending or sitting position. All children with LBP had overweight bookbags. There were 32% family-related cases of lLBP. Conclusions: LBP was diagnosed in 21.3% of children of the mountain region. The main risk-factors were heredity and hard physical activity. Disclosure: None declared
S277 KANGAROO CARE COMBINED WITH SUCROSE AND PACIFIER TO REDUCE PAIN RESPONSES OF PRETERM NEONATES TO VENIPUNCTURE A. Fernandes1 *, C.C. Johnston2 . 1 Coimbra School of Nursing, Coimbra, Portugal; 2 McGill University, Montreal, QC, Canada Background and Aims: Preterm neonates in intensive care units endure frequent diagnostic and treatment procedures that may cause pain. Interventions to decrease the pain experienced by these neonates are needed. The aim of this study was to compare the efficacy of the combination of sucrose, pacifier and kangaroo mother care (S+KMC), with that of sucrose and pacifier (S), in reducing pain responses of preterm neonates undergoing venipuncture. Methods: A randomized, single-blind, controlled trial was conducted in two neonatal intensive care units in Portugal. Preterm neonates (n = 110), stratified by gestational age (28–316/7 and 32–366/7 ), were randomly assigned to receive S+KMC or S for venipuncture. Measures of pain responses were the Premature Infant Pain Profile (PIPP) and recovery time. Physiological variables were recorded continuously. Facial actions were video recorded and coded blindly. Main statistical analysis was conducted using a twofactor repeated-measures ANOVA with intervention and gestational age as between-subjects factor and phase of procedure as withinsubjects factor. Results: Regarding the PIPP, no difference was found between intervention groups. However, compared to infants in S, infants in S+KMC displayed significantly less brow bulge and eye squeeze; were more likely to have recovered heart rate baseline values at 60 and 90 seconds after the procedure, if they were 32 weeks gestational age and above; and were more likely to be asleep during the procedure. No adverse events occurred that needed support. Conclusions: Combining kangaroo care to sucrose and pacifier is safe and effective to reduce pain responses of preterm neonates 28–36 weeks undergoing venipuncture. Disclosure: None declared
S278 PAIN SENSITIVITY AND PAIN COPING OF CHILDREN WITH DOWN’S SYNDROME: A PILOT STUDY A.J. Valkenburg *, M. Van Dijk, D. Tibboel. Pediatric Surgery and Pain Expertise Center, Erasmus University Medical Center – Sophia Children’s Hospital, Rotterdam, The Netherlands Background and Aims: Children with Down’s syndrome (DS) need frequent surgery for congenital anomalies. Adults with DS show altered pain sensitivity. The aim of this pilot study was to evaluate pain sensitivity and pain coping of children with DS.
Methods: The study was approved by our IRB. Informed consent was obtained from all parents. Tests included QST (TSA-II; detection and pain thresholds) and a reaction-time test. Parents completed the Vineland Adaptive Behaviour Scale, Pain Coping Questionnaire and Chronic Pain Questionnaire. Results: We included 6 girls and 5 boys with DS aged 8 to 14 years old. Median developmental age was 54 [IQR 47 to 60] months. Mean detection thresholds for cold were 26.7 (SD 2.1) °C and 37.1 (SD 1.7) °C for warmth. Compared to reference values, detection thresholds were significantly higher in the children with DS (P < 0.0001). Pain threshold results were not valid since the children were easily distracted during testing or did not want to finish pain threshold measurements. Seven parents rated the pain sensitivity of their child as hyposensitive, 3 as equal sensitive and 1 as hypersensitive. Four children experienced non-chronic pain (<3 months). Children with DS less often used positive self-statements or information seeking, problem solving and internalizing strategies as pain coping behaviour than reported in reference studies. Conclusions: Children with DS were less sensitive for the detection of cold and warmth stimuli. The procedure for testing pain thresholds might be too difficult and should be adapted for future use in children with DS. Disclosure: None declared
S279 PREVALENCE OF PROLONGED PAIN IN NEONATES M. Noel ¨ de Tilly1 *, C. Stadelmann-Diaw2 , A.-S. Ramelet1,3 . 1 Institut Universitaire de Formation et de Recherche en Soins – IUFRS, Universit´e de Lausanne, 2 D´epartement M´edico-Chirurgical de P´ediatrie, Centre Hospitalier Universitaire Vaudois (CHUV), 3 Fili`ere Infirmi`ere, Haute E´cole Cantonale Vaudoise de Sant´e – HECVSant´e, Lausanne, Switzerland Background and Aims: Hospitalized infants are exposed to numerous painful stimuli due to their condition and the required procedures. During their relatively long hospital stay, these infants are at risk of experiencing prolonged pain. As opposed to acute pain, prolonged pain lasts longer and requires longer recovery. Ongoing pain is not systematically evaluated and thus could be overlooked. The aim of this study was to determine the prevalence of prolonged pain in neonates. Methods: This prospective prevalence study was undertaken in a Level III neonatal unit of a tertiary referral hospital in Western Switzerland over a three-month period. Prolonged pain was assessed in infants aged between 3 and 14 days by a trained researcher on three occasions, using the COMFORTneo scale. The cut-off score for ongoing pain is 14. The maximum pain score (painmax ) for each infant as well as the total observations were calculated to determine the prevalence. Results: Sixty infants aged between 3 and 14 days (m 5.9±2.3) were included, providing 165 scores. Twenty-eight infants (46.7%) had a painmax score ≥14. Of the 165 observations, 34 (20.6%) recorded a COMFORTneo score ≥14. The infants who experienced ongoing pain had undergone an average of 78.3±47.7 painful procedures. Conclusions: Our results are comparable to those reported in the COMFORTneo scale validation study, and highlight the importance of assessing prolonged pain to ensure appropriate management. Further research to determine the predictors of prolonged pain with a more appropriate sample size is warranted. Disclosure: None declared
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
Methods: 208 school children in age 10–17 years old were examined. It was used objective examination and riskfactors questionnaire for person with LBP (Povoroznyuk V.V., Dzerovych N.I., 2003). Results: 21.3% school children had complaints in LBP (19% – boys, 23% – girls). The age-related peak of symptom was in 14–15 years among girls, at 14 and 16 years among boys (22.2% and 27.7% correspondingly). The localization of the pain was in lumber region in 45.5% children, and combination of lumber and thoracic or cervical pain in 25.5%. The mild pain intensity was in 30.8% girls and moderate – in 26.9% girls and 55.6% boys. 62% children had pain in day-time with duration not more than 30 min. LBP was increasing with heavy load lifting or during continuous bending or sitting position. All children with LBP had overweight bookbags. There were 32% family-related cases of lLBP. Conclusions: LBP was diagnosed in 21.3% of children of the mountain region. The main risk-factors were heredity and hard physical activity. Disclosure: None declared
S277 KANGAROO CARE COMBINED WITH SUCROSE AND PACIFIER TO REDUCE PAIN RESPONSES OF PRETERM NEONATES TO VENIPUNCTURE A. Fernandes1 *, C.C. Johnston2 . 1 Coimbra School of Nursing, Coimbra, Portugal; 2 McGill University, Montreal, QC, Canada Background and Aims: Preterm neonates in intensive care units endure frequent diagnostic and treatment procedures that may cause pain. Interventions to decrease the pain experienced by these neonates are needed. The aim of this study was to compare the efficacy of the combination of sucrose, pacifier and kangaroo mother care (S+KMC), with that of sucrose and pacifier (S), in reducing pain responses of preterm neonates undergoing venipuncture. Methods: A randomized, single-blind, controlled trial was conducted in two neonatal intensive care units in Portugal. Preterm neonates (n = 110), stratified by gestational age (28–316/7 and 32–366/7 ), were randomly assigned to receive S+KMC or S for venipuncture. Measures of pain responses were the Premature Infant Pain Profile (PIPP) and recovery time. Physiological variables were recorded continuously. Facial actions were video recorded and coded blindly. Main statistical analysis was conducted using a twofactor repeated-measures ANOVA with intervention and gestational age as between-subjects factor and phase of procedure as withinsubjects factor. Results: Regarding the PIPP, no difference was found between intervention groups. However, compared to infants in S, infants in S+KMC displayed significantly less brow bulge and eye squeeze; were more likely to have recovered heart rate baseline values at 60 and 90 seconds after the procedure, if they were 32 weeks gestational age and above; and were more likely to be asleep during the procedure. No adverse events occurred that needed support. Conclusions: Combining kangaroo care to sucrose and pacifier is safe and effective to reduce pain responses of preterm neonates 28–36 weeks undergoing venipuncture. Disclosure: None declared
S278 PAIN SENSITIVITY AND PAIN COPING OF CHILDREN WITH DOWN’S SYNDROME: A PILOT STUDY A.J. Valkenburg *, M. Van Dijk, D. Tibboel. Pediatric Surgery and Pain Expertise Center, Erasmus University Medical Center – Sophia Children’s Hospital, Rotterdam, The Netherlands Background and Aims: Children with Down’s syndrome (DS) need frequent surgery for congenital anomalies. Adults with DS show altered pain sensitivity. The aim of this pilot study was to evaluate pain sensitivity and pain coping of children with DS.
Methods: The study was approved by our IRB. Informed consent was obtained from all parents. Tests included QST (TSA-II; detection and pain thresholds) and a reaction-time test. Parents completed the Vineland Adaptive Behaviour Scale, Pain Coping Questionnaire and Chronic Pain Questionnaire. Results: We included 6 girls and 5 boys with DS aged 8 to 14 years old. Median developmental age was 54 [IQR 47 to 60] months. Mean detection thresholds for cold were 26.7 (SD 2.1) °C and 37.1 (SD 1.7) °C for warmth. Compared to reference values, detection thresholds were significantly higher in the children with DS (P < 0.0001). Pain threshold results were not valid since the children were easily distracted during testing or did not want to finish pain threshold measurements. Seven parents rated the pain sensitivity of their child as hyposensitive, 3 as equal sensitive and 1 as hypersensitive. Four children experienced non-chronic pain (<3 months). Children with DS less often used positive self-statements or information seeking, problem solving and internalizing strategies as pain coping behaviour than reported in reference studies. Conclusions: Children with DS were less sensitive for the detection of cold and warmth stimuli. The procedure for testing pain thresholds might be too difficult and should be adapted for future use in children with DS. Disclosure: None declared
S279 PREVALENCE OF PROLONGED PAIN IN NEONATES M. Noel ¨ de Tilly1 *, C. Stadelmann-Diaw2 , A.-S. Ramelet1,3 . 1 Institut Universitaire de Formation et de Recherche en Soins – IUFRS, Universit´e de Lausanne, 2 D´epartement M´edico-Chirurgical de P´ediatrie, Centre Hospitalier Universitaire Vaudois (CHUV), 3 Fili`ere Infirmi`ere, Haute E´cole Cantonale Vaudoise de Sant´e – HECVSant´e, Lausanne, Switzerland Background and Aims: Hospitalized infants are exposed to numerous painful stimuli due to their condition and the required procedures. During their relatively long hospital stay, these infants are at risk of experiencing prolonged pain. As opposed to acute pain, prolonged pain lasts longer and requires longer recovery. Ongoing pain is not systematically evaluated and thus could be overlooked. The aim of this study was to determine the prevalence of prolonged pain in neonates. Methods: This prospective prevalence study was undertaken in a Level III neonatal unit of a tertiary referral hospital in Western Switzerland over a three-month period. Prolonged pain was assessed in infants aged between 3 and 14 days by a trained researcher on three occasions, using the COMFORTneo scale. The cut-off score for ongoing pain is 14. The maximum pain score (painmax ) for each infant as well as the total observations were calculated to determine the prevalence. Results: Sixty infants aged between 3 and 14 days (m 5.9±2.3) were included, providing 165 scores. Twenty-eight infants (46.7%) had a painmax score ≥14. Of the 165 observations, 34 (20.6%) recorded a COMFORTneo score ≥14. The infants who experienced ongoing pain had undergone an average of 78.3±47.7 painful procedures. Conclusions: Our results are comparable to those reported in the COMFORTneo scale validation study, and highlight the importance of assessing prolonged pain to ensure appropriate management. Further research to determine the predictors of prolonged pain with a more appropriate sample size is warranted. Disclosure: None declared