Imperative Role of Education of ICU Nurses regarding Postoperative Pain Management After Pediatric Cardiac Surgery

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 children. 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.