Opioid Administration for Postoperative Pain in Children With Developmental Delay: Parent and Nurse Satisfaction

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Abstract

Introduction

Parent-/nurse-controlled analgesia (PNCA) has been shown to be safe and effective for a variety of pediatric patient populations, yet no studies were found that assessed parent or nurse satisfaction with this opioid delivery system. The purpose of this study was to explore parent and nurse satisfaction and factors influencing satisfaction with three opioid delivery systems: PNCA with and without a basal infusion and intravenous, as needed (PRN) opioids for children with developmental delay.

Methods

As part of a randomized controlled trial, parent satisfaction was measured using a modified Parent Total Quality Pain Management Instrument (Foster & Varni, 2002). Nurses were asked to complete an investigator-developed survey each shift.

Results

Parents reported high levels of satisfaction regardless of the opioid delivery system, but parents in the PRN group reported longer wait times for medication and wanted more of a say in their child’s pain management. PNCA was described by parents as convenient and fast, whereas PRN opioids were described as inconvenient and burdensome for nurses. Nurses’ satisfaction was significantly lower for PRN opioids than PNCA owing to significantly longer administration times and less parental involvement.

Discussion

To our knowledge, this is the first randomized controlled trial to explore parent and nurse satisfaction with various opioid delivery systems. Whereas all three systems resulted in high levels of parent satisfaction, nurses were more satisfied with PNCA. Adding this element of satisfaction with PNCA to the already established efficacy and safety adds support for the consideration of PNCA for children with developmental delay.

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