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Journal of Pediatric Psychology 14(3) pp. 433-448, 1989
© 1989 Society of Pediatric Psychology

research-article

Patterns of PRN Analgesic Drug Administration in Children Following Elective Surgery1

Joseph P. Bush2, Grayson N. Holmbeck and Janice L. Cockrell

Departments of Psychology, Pediatrics, and Pediatric Dentistry, Virginia Commonwealth University, Loyola University of Chicago, Department of Physical Medicine and Rehabilitation, Children's Hospital Richmond, Virginia

2All correspondence should be addressed to Joseph P. Bush, Department of Psychology, Virginia Commonwealth University, Box 2018, 806 W. Franklin Street, Richmond, Virginia 23284-2018

Conducted chart review study of 114 4- to 14-year-olds hospitalized for elective surgery to investigate analgesic medication patterns. Correcting for body weight and different drug potencies, correlations were examined between analgesics, child age, painfulness of recovery, and seriousness of surgical procedure. Weight-adjusted analgesics prescribed and delivered PRN were unrelated to painfulness of procedure and age. Expert ratings of the seriousness of anticipated sequelae were found to be a modest but significant predictor of analgesics. Results suggest that PRN prescription of analgesics in children essentially guarantees very low drug delivery without achieving individualized pain management. Possible interpretations and suggestions for research into effects of practitioner attributions of seriousness on clinical decision making are discussed, along with implications for other explanations of inadequate analgesic practices.

Key words: pain; analgesia; PRN medications; surgery.


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