| Analgesics

Language Barriers Affect Children’s Pain Management

Further Studies Needed to Identify Strategies

The journal Children discussed a study of low English proficiency (LEP) and pain management for pediatric patients who had appendectomies at a hospital in San Francisco. Although LEP and English proficient (EP) groups received the same amount of opioid medication intraoperatively, the LEP patients:

  • Had >2 times the odds of receiving any opioid in the PACU
  • Received more oral morphine equivalents than EP patients
  • Had almost double the odds of having no pain score recorded during their PACU recovery period

Previous studies have shown that language barriers encountered in the hospital increase the risk of adverse events in adults. This study examined PACU pain management for pediatric patients undergoing appendectomy, and noted dissatisfaction with the amount of time and quality of care provided by their children’s clinicians was noted in parents of children whose primary language is not English. Also, children whose families have LEP receive fewer postoperative daily pain assessments and require higher pain scores before receiving opioid medications. Among the conclusions: “LEP children, particularly those over 5 years old and therefore more likely to undergo a verbal, question-based pain assessment that might require an interpreter (rather than a non-verbal, face-scale or other clinical assessment), were also more likely not to undergo any objective pain assessment in the PACU. Approximately 40% of patients without a documented pain score still received opioid analgesia.”

 

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