Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Echocardiography Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
Background: Management and evaluation of pain in children can be challenging due to difficulties in
expression and verbalization. The imperative role of nurses in the assessment and management
of pain should be considered. The aim of this study was to evaluate the role of the education of
ICU nurses in pain assessment and measurement in order to reduce postoperative pain in
Methods: In this clinical trial, 146 children aged 3 to 15 years who underwent cardiac surgery were
allocated to 2 groups. The control group (n=73) was managed routinely in that analgesics were
administered as needed at the discretion of each anesthesiologist. In the trained nurses group
(n=73), the ICU nurses received an education program including a pain assessment and
treatment protocol. In both groups, pain scores were evaluated and recorded according to the
Wong–Baker FACES Pain Rating Scale on the first and second postoperative day. Analgesics
were administered to alleviate moderate and severe pain, and the nurse was asked to record all
pain scores and analgesic drug doses.
Results: Pain scores on the second day decreased in both groups (P<0.001); however, this decreasing
trend was steeper in the patients with trained nurses. Analgesic use was higher in the trained
nurses group than in the control group (P=0.0001). The postoperative use of sedative drugs in
the trained nurses group was less than that in the control group on the first postsurgical day but
not on the second day (P=0.120).
Conclusions: Implementation of our pain management protocol by ICU nurses led to an increase in
analgesic use and a decrease in sedative drug administration and better pain control in pediatric
patients undergoing cardiac surgery.