Low Relevancy of Outcome Measurements of Studies of Pediatric Pain in the Emergency Department

Many children visiting the emergency department (ED) experience pain. Several pharmacological and nonpharmacological interventions are used for pain control. Little is known about the outcome measurements in studies about pain in children in the ED. Furthermore, it is not known if complete pain relief was reached. METHODS: PubMed, the Cochrane Database of Systematic Reviews, and EMBASE were searched for articles on clinical trials for pain relief in children in the ED. Inclusion criteria contained predictable and identifiable pain such as after trauma or during procedures. RESULTS: Of 620 articles found, 45 fulfilled the criteria. Twenty studies (44%) used pharmacological interventions, and 25 (56%) studied nonpharmacological interventions. In 24 studies (53%), a statistically significant pain reduction was described in the intervention group. In 21 studies (47%), a clinically relevant reduction in pain was found. In only 1 study, the reported aim was to reach absence of pain. CONCLUSION: Half of the interventions decreased pain in children in the ED. However, most studies did not aim at complete pain relief. Even in intervention groups with statistically significant decrease in pain, children still had pain. Children in the ED deserve better. Complete pain relief should be the goal of any intervention for these children in the ED. Studies on pain treatment in the ED should have complete pain relief as primary end point.