Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review
Background. Pain management for children with musculoskeletal injuries is suboptimal and, in the absence of clear evidence-based guidelines, varies significantly. Objective. To systematically review the most effective pain management for children presenting to the emergency department with musculosk...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2016/4809394 |
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| author | Sylvie Le May Samina Ali Christelle Khadra Amy L. Drendel Evelyne D. Trottier Serge Gouin Naveen Poonai |
| author_facet | Sylvie Le May Samina Ali Christelle Khadra Amy L. Drendel Evelyne D. Trottier Serge Gouin Naveen Poonai |
| author_sort | Sylvie Le May |
| collection | DOAJ |
| description | Background. Pain management for children with musculoskeletal injuries is suboptimal and, in the absence of clear evidence-based guidelines, varies significantly. Objective. To systematically review the most effective pain management for children presenting to the emergency department with musculoskeletal injuries. Methods. Electronic databases were searched systematically for randomized controlled trials of pharmacological and nonpharmacological interventions for children aged 0–18 years, with musculoskeletal injury, in the emergency department. The primary outcome was the risk ratio for successful reduction in pain scores. Results. Of 34 studies reviewed, 8 met inclusion criteria and provided data on 1169 children from 3 to 18 years old. Analgesics used greatly varied, making comparisons difficult. Only two studies compared the same analgesics with similar routes of administration. Two serious adverse events occurred without fatalities. All studies showed similar pain reduction between groups except one study that favoured ibuprofen when compared to acetaminophen. Conclusions. Due to heterogeneity of medications and routes of administration in the articles reviewed, an optimal analgesic cannot be recommended for all pain categories. Larger trials are required for further evaluation of analgesics, especially trials combining a nonopioid with an opioid agent or with a nonpharmacological intervention. |
| format | Article |
| id | doaj-art-cdcc2b76e09b43c9b472a96931170055 |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-cdcc2b76e09b43c9b472a969311700552025-02-03T01:22:19ZengWileyPain Research and Management1203-67651918-15232016-01-01201610.1155/2016/48093944809394Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic ReviewSylvie Le May0Samina Ali1Christelle Khadra2Amy L. Drendel3Evelyne D. Trottier4Serge Gouin5Naveen Poonai6Faculty of Nursing, University of Montreal, Montreal, QC, H3T 1A8, CanadaWomen and Children’s Health Research Institute, Edmonton, AB, T6G 1C9, CanadaFaculty of Nursing, University of Montreal, Montreal, QC, H3T 1A8, CanadaDepartment of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USACHU Sainte-Justine Research Centre, Montreal, QC, H3T 1C5, CanadaCHU Sainte-Justine Research Centre, Montreal, QC, H3T 1C5, CanadaChildren’s Hospital, London Health Sciences Centre, London, ON, N6A 5W9, CanadaBackground. Pain management for children with musculoskeletal injuries is suboptimal and, in the absence of clear evidence-based guidelines, varies significantly. Objective. To systematically review the most effective pain management for children presenting to the emergency department with musculoskeletal injuries. Methods. Electronic databases were searched systematically for randomized controlled trials of pharmacological and nonpharmacological interventions for children aged 0–18 years, with musculoskeletal injury, in the emergency department. The primary outcome was the risk ratio for successful reduction in pain scores. Results. Of 34 studies reviewed, 8 met inclusion criteria and provided data on 1169 children from 3 to 18 years old. Analgesics used greatly varied, making comparisons difficult. Only two studies compared the same analgesics with similar routes of administration. Two serious adverse events occurred without fatalities. All studies showed similar pain reduction between groups except one study that favoured ibuprofen when compared to acetaminophen. Conclusions. Due to heterogeneity of medications and routes of administration in the articles reviewed, an optimal analgesic cannot be recommended for all pain categories. Larger trials are required for further evaluation of analgesics, especially trials combining a nonopioid with an opioid agent or with a nonpharmacological intervention.http://dx.doi.org/10.1155/2016/4809394 |
| spellingShingle | Sylvie Le May Samina Ali Christelle Khadra Amy L. Drendel Evelyne D. Trottier Serge Gouin Naveen Poonai Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review Pain Research and Management |
| title | Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review |
| title_full | Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review |
| title_fullStr | Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review |
| title_full_unstemmed | Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review |
| title_short | Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review |
| title_sort | pain management of pediatric musculoskeletal injury in the emergency department a systematic review |
| url | http://dx.doi.org/10.1155/2016/4809394 |
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