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Key studies English (29) French All (29)

Key Study: Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Visit

Daoust R, Paquet J, Bailey B, Lavigne G, Piette E, Sanogo K, Chauny JM

Objectives: This study aimed to ascertain the association between self-reported pain intensity and vital signs in both emergency department (ED) patients and a subgroup of patients with diagnosed conditions known to produce significant pain.

Key Study: Oral administration of morphine versus ibuprofen to manage postfracture pain in children: a randomized trial

Visit

Poonai N, Bhullar G, Lin K, Papini A, Mainprize D, Howard J, Teefy J, Bale M,...

Recent warnings from Health Canada regarding codeine for children have led to increased use of nonsteroidal anti-inflammatory drugs and morphine for common injuries such as fractures. Our objective was to determine whether morphine administered orally has superior efficacy to ibuprofen in fracture-related pain.

Key Study: Association of race and ethnicity with management of abdominal pain in the emergency department

Visit

Johnson TJ, Weaver MD, Borrero S, Davis EM, Myaskovsky L, Zuckerbraun NS, Kra...

Objective: To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs).

Key Study: Reliability of the visual analog scale in children with acute pain in the emergency department

Visit

Bailey B, Gravel J, Daoust R

In children, many psychometric properties of the visual analogue scale (VAS) are known, including the minimum clinically significant difference (10mm on a 100-mm VAS). However, its imprecision or reliability is not well known. Thus, in order to determine the reliability of this scale, a prospective cohort study was performed in patients aged 8-17 years presenting to a pediatric emergency department with acute pain.

Key Study: Equivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: a randomized controlled trial

Visit

Borland M, Milsom S, Esson A

Objective: Intranasal fentanyl's (INF) effectiveness is established using highly concentrated INF (HINF). Standard concentration INF (SINF) is more widely available. We aimed to illustrate the equivalence of SINF to HINF.

Key Study: Pain assessment for children: overcoming challenges and optimizing care

Visit

Drendel AL, Kelly BT, Ali S

This review will highlight the many complexities of the assessment of pain for the pediatric patient. In addition, a variety of factors that affect the self-report of pain in children will be identified.

Key Study: Pain management of musculoskeletal injuries in children: current state and future directions

Visit

Ali S, Drendel AL, Kircher J, Beno S

Objectives: Upon completion of this CME article, the reader should be better able to (1) distinguish multiple nonpharmacological techniques for minimizing and treating pain and anxiety in children with musculoskeletal injuries, (2) apply recent medical literature in deciding pharmacological strategies for the treatment of children with musculoskeletal injuries, and (3) interpret the basic principles of pharmacogenomics and how they relate to analgesic efficacy.

Key Study: Use of intranasal fentanyl for the relief of pediatric orthopedic trauma pain

Visit

Saunders M, Adelgais K, Nelson D

Objectives: The objective was to evaluate the use of a single 2 g/kg dose of intranasal fentanyl as analgesia for painful orthopedic injuries in children presenting to a pediatric emergency department (ED).

Key Study: Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department

Visit

Trottier ED, Bailey B, Dauphin-Pierre S, Gravel J

Objective: To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED.

Key Study: A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain

Visit

Drendel AL, Gorelick MH, Weisman SJ, Lyon R, Brousseau DC, Kim MK

Study Objective: We compare the treatment of pain in children with arm fractures by ibuprofen 10 mg/kg versus acetaminophen with codeine 1 mg/kg/dose (codeine component).

Key Study: Ibuprofen provides analgesia equivalent to acetaminophen-codeine in the treatment of acute pain in children with extremity injuries: a randomized clinical trial

Visit

Friday JH, Kanegaye JT, McCaslin I, Zheng A, Harley JR

Objectives: This study compared the analgesic effectiveness of acetaminophen-codeine with that of ibuprofen for children with acute traumatic extremity pain, with the hypothesis that the two medications would demonstrate equivalent reduction in pain scores in an emergency department (ED) setting.

Key Study: Comparative review of the clinical use of intranasal fentanyl versus morphine in a paediatric emergency department

Visit

Borland ML, Clark LJ, Esson A

Objectives: Comparison of intranasal fentanyl (INF) and parenteral morphine in children in an ED. Primary objective was to compare time to analgesia from presentation, with secondary objectives to assess patient profiles, specifics of opiate analgesics used plus rate of i.v. access for analgesia alone.

Key Study: Oxycodone versus codeine for triage pain in children with suspected forearm fracture: a randomized controlled trial

Visit

Charney RL, Yan Y, Schootman M, Kennedy RM, Luhmann JD

Objective: To compare the efficacy of pain reduction of triage oxycodone (O) versus codeine (C) to children with suspected forearm fractures.

Key Study: Efficacy and impact of intravenous morphine before surgical consultation in children with right lower quadrant pain suggestive of appendicitis: a randomized controlled trial

Visit

Bailey B, Bergeron S, Gravel J, Bussieres JF, Bensoussan A

Study Objective: The evidence supporting the use of analgesia in children with abdominal pain suggestive of appendicitis is limited. The objectives of the study are to evaluate the efficacy of morphine before surgical consultation in children presenting to the pediatric emergency department (ED) with right lower quadrant pain suggestive of appendicitis and determine whether it has an impact on the time between arrival in the ED and the surgical decision.

Key Study: Comparison of four pain scales in children with acute abdominal pain in a pediatric emergency department

Visit

Bailey B, Bergeron S, Gravel J, Daoust R

Study Objective: In children, the agreement between the many scales used to document the intensity of pain is not well known. Thus, to determine the agreement, we evaluate the visual analog scale, the standardized color analog scale, the Wong-Baker FACES Pain Rating Scale, and a verbal numeric scale in children with acute abdominal pain suggestive of appendicitis in a pediatric emergency department (ED).

Key Study: A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department

Visit

Borland M, Jacobs I, King B, O'Brien D

Study Objective: We compare the efficacy of intranasal fentanyl versus intravenous morphine in a pediatric population presenting to an emergency department (ED) with acute long-bone fractures.

Key Study: A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma

Visit

Clark E, Plint AC, Correll R, Gaboury I, Passi B

Objective: Our goal was to determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal injuries.

Key Study: Effectiveness of oxycodone, ibuprofen, or the combination in the initial management of orthopedic injury-related pain in children

Visit

Koller DM, Myers AB, Lorenz D, Godambe SA

Objective: Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have demonstrated efficacy for this indication, but no studies have compared these drugs in children. Our objective was to investigate the effectiveness of oxycodone, ibuprofen, or their combination for the management of orthopedic injury-related pain in children.

Key Study: Pain assessment for pediatric patients in the emergency department

Visit

Drendel AL, Brousseau DC, Gorelick MH

Objective: To examine the relationship between pediatric patient visit characteristics and pain score documentation in the emergency department (ED) and determine whether documentation of a pain score is associated with increased analgesic use.

Key Study: Early analgesia for children with acute abdominal pain

Visit

Green R, Bulloch B, Kabani A, Hancock BJ, Tenenbein M

Objectives: The objectives of this study were to determine whether the administration of morphine to children with acute abdominal pain would impede the diagnosis of appendicitis and to determine the efficacy of morphine in relieving the pain.

Key Study: Oxycodone vs placebo in children with undifferentiated abdominal pain: a randomized, double-blind clinical trial of the effect of analgesia on diagnostic accuracy

Visit

Kokki H, Lintula H, Vanamo K, Heiskanen M, Eskelinen M

Objective: To evaluate the effects of buccal oxycodone on pain relief, physical examination findings, diagnostic accuracy, and final clinical outcomes in children with acute abdominal pain.

Key Study: Treatment of pediatric migraine headaches: a randomized, double-blind trial of prochlorperazine versus ketorolac

Visit

Brousseau DC, Duffy SJ, Anderson AC, Linakis JG

Study Objective: We compare the effectiveness of intravenous ketorolac and intravenous prochlorperazine in the treatment of pediatric migraine headaches.

Key Study: The anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations

Visit

White NJ, Kim MK, Brousseau DC, Bergholte J, Hennes H

Objectives: To determine the effectiveness of lidocaine-adrenaline-tetracaine (LAT) in providing adequate anesthesia for the repair of finger lacerations and to monitor the risk of digital ischemia following application of LAT gel to finger lacerations.

Key Study: Emergency department analgesia for fracture pain

Visit

Brown JC, Klein EJ, Lewis CW, Johnston BD, Cummings P

Study Objectives: We analyze records of all emergency department (ED) patients with extremity or clavicular fractures to describe analgesic use, compare analgesia between adults and children, and compare analgesia between the subset of these adults and children with documented moderate or severe pain. Among children, we compare treatment between pediatric and nonpediatric facilities.

Key Study: A randomized clinical trial of analgesia in children with acute abdominal pain

Visit

Kim MK, Strait RT, Sato TT, Hennes HM

Objective: To evaluate the effects of intravenous morphine on pain reduction, physical examination, and diagnostic accuracy in children with acute abdominal pain.

Key Study: The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement

Visit

Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B

The Faces Pain Scale (FPS; Bieri et al., Pain 41 (1990) 139) is a self-report measure used to assess the intensity of children's pain. Three studies were carried out to revise the original scale and validate the adapted version.

Key Study: A prospective randomized pilot comparison of intranasal fentanyl and intramuscular morphine for analgesia in children presenting to the emergency department with clinical fractures

Visit

Younge PA, Nicol MF, Kendall JM, Harrington AP

Objective:To evaluate the tolerability and efficacy of intranasal fentanyl analgesia for children.

Key Study: The FLACC: a behavioral scale for scoring postoperative pain in young children

Visit

Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S

Purpose: To evaluate the reliability and validity of the FLACC Pain Assessment Tool which incorporates five categories of pain behaviors: facial expression; leg movement; activity; cry; and consolability.

Key Study: Reliability and validity of the Faces and Word Descriptor Scales to measure procedural pain

Visit

Keck JF, Gerkensmeyer JE, Joyce BA, Schade JG

Reliability and validity of the Faces and Word Descriptor Scales to measure pain in verbal children undergoing painful procedures were assessed.

Key Study: Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Visit

Daoust R, Paquet J, Bailey B, Lavigne G, Piette E, Sanogo K, Chauny JM

Objectives: This study aimed to ascertain the association between self-reported pain intensity and vital signs in both emergency department (ED) patients and a subgroup of patients with diagnosed conditions known to produce significant pain.

Key Study: Oral administration of morphine versus ibuprofen to manage postfracture pain in children: a randomized trial

Visit

Poonai N, Bhullar G, Lin K, Papini A, Mainprize D, Howard J, Teefy J, Bale M,...

Recent warnings from Health Canada regarding codeine for children have led to increased use of nonsteroidal anti-inflammatory drugs and morphine for common injuries such as fractures. Our objective was to determine whether morphine administered orally has superior efficacy to ibuprofen in fracture-related pain.

Key Study: Association of race and ethnicity with management of abdominal pain in the emergency department

Visit

Johnson TJ, Weaver MD, Borrero S, Davis EM, Myaskovsky L, Zuckerbraun NS, Kra...

Objective: To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs).

Key Study: Reliability of the visual analog scale in children with acute pain in the emergency department

Visit

Bailey B, Gravel J, Daoust R

In children, many psychometric properties of the visual analogue scale (VAS) are known, including the minimum clinically significant difference (10mm on a 100-mm VAS). However, its imprecision or reliability is not well known. Thus, in order to determine the reliability of this scale, a prospective cohort study was performed in patients aged 8-17 years presenting to a pediatric emergency department with acute pain.

Key Study: Equivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: a randomized controlled trial

Visit

Borland M, Milsom S, Esson A

Objective: Intranasal fentanyl's (INF) effectiveness is established using highly concentrated INF (HINF). Standard concentration INF (SINF) is more widely available. We aimed to illustrate the equivalence of SINF to HINF.

Key Study: Pain assessment for children: overcoming challenges and optimizing care

Visit

Drendel AL, Kelly BT, Ali S

This review will highlight the many complexities of the assessment of pain for the pediatric patient. In addition, a variety of factors that affect the self-report of pain in children will be identified.

Key Study: Pain management of musculoskeletal injuries in children: current state and future directions

Visit

Ali S, Drendel AL, Kircher J, Beno S

Objectives: Upon completion of this CME article, the reader should be better able to (1) distinguish multiple nonpharmacological techniques for minimizing and treating pain and anxiety in children with musculoskeletal injuries, (2) apply recent medical literature in deciding pharmacological strategies for the treatment of children with musculoskeletal injuries, and (3) interpret the basic principles of pharmacogenomics and how they relate to analgesic efficacy.

Key Study: Use of intranasal fentanyl for the relief of pediatric orthopedic trauma pain

Visit

Saunders M, Adelgais K, Nelson D

Objectives: The objective was to evaluate the use of a single 2 g/kg dose of intranasal fentanyl as analgesia for painful orthopedic injuries in children presenting to a pediatric emergency department (ED).

Key Study: Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department

Visit

Trottier ED, Bailey B, Dauphin-Pierre S, Gravel J

Objective: To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED.

Key Study: A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain

Visit

Drendel AL, Gorelick MH, Weisman SJ, Lyon R, Brousseau DC, Kim MK

Study Objective: We compare the treatment of pain in children with arm fractures by ibuprofen 10 mg/kg versus acetaminophen with codeine 1 mg/kg/dose (codeine component).

Key Study: Ibuprofen provides analgesia equivalent to acetaminophen-codeine in the treatment of acute pain in children with extremity injuries: a randomized clinical trial

Visit

Friday JH, Kanegaye JT, McCaslin I, Zheng A, Harley JR

Objectives: This study compared the analgesic effectiveness of acetaminophen-codeine with that of ibuprofen for children with acute traumatic extremity pain, with the hypothesis that the two medications would demonstrate equivalent reduction in pain scores in an emergency department (ED) setting.

Key Study: Comparative review of the clinical use of intranasal fentanyl versus morphine in a paediatric emergency department

Visit

Borland ML, Clark LJ, Esson A

Objectives: Comparison of intranasal fentanyl (INF) and parenteral morphine in children in an ED. Primary objective was to compare time to analgesia from presentation, with secondary objectives to assess patient profiles, specifics of opiate analgesics used plus rate of i.v. access for analgesia alone.

Key Study: Oxycodone versus codeine for triage pain in children with suspected forearm fracture: a randomized controlled trial

Visit

Charney RL, Yan Y, Schootman M, Kennedy RM, Luhmann JD

Objective: To compare the efficacy of pain reduction of triage oxycodone (O) versus codeine (C) to children with suspected forearm fractures.

Key Study: Efficacy and impact of intravenous morphine before surgical consultation in children with right lower quadrant pain suggestive of appendicitis: a randomized controlled trial

Visit

Bailey B, Bergeron S, Gravel J, Bussieres JF, Bensoussan A

Study Objective: The evidence supporting the use of analgesia in children with abdominal pain suggestive of appendicitis is limited. The objectives of the study are to evaluate the efficacy of morphine before surgical consultation in children presenting to the pediatric emergency department (ED) with right lower quadrant pain suggestive of appendicitis and determine whether it has an impact on the time between arrival in the ED and the surgical decision.

Key Study: Comparison of four pain scales in children with acute abdominal pain in a pediatric emergency department

Visit

Bailey B, Bergeron S, Gravel J, Daoust R

Study Objective: In children, the agreement between the many scales used to document the intensity of pain is not well known. Thus, to determine the agreement, we evaluate the visual analog scale, the standardized color analog scale, the Wong-Baker FACES Pain Rating Scale, and a verbal numeric scale in children with acute abdominal pain suggestive of appendicitis in a pediatric emergency department (ED).

Key Study: A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department

Visit

Borland M, Jacobs I, King B, O'Brien D

Study Objective: We compare the efficacy of intranasal fentanyl versus intravenous morphine in a pediatric population presenting to an emergency department (ED) with acute long-bone fractures.

Key Study: A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma

Visit

Clark E, Plint AC, Correll R, Gaboury I, Passi B

Objective: Our goal was to determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal injuries.

Key Study: Effectiveness of oxycodone, ibuprofen, or the combination in the initial management of orthopedic injury-related pain in children

Visit

Koller DM, Myers AB, Lorenz D, Godambe SA

Objective: Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have demonstrated efficacy for this indication, but no studies have compared these drugs in children. Our objective was to investigate the effectiveness of oxycodone, ibuprofen, or their combination for the management of orthopedic injury-related pain in children.

Key Study: Pain assessment for pediatric patients in the emergency department

Visit

Drendel AL, Brousseau DC, Gorelick MH

Objective: To examine the relationship between pediatric patient visit characteristics and pain score documentation in the emergency department (ED) and determine whether documentation of a pain score is associated with increased analgesic use.

Key Study: Early analgesia for children with acute abdominal pain

Visit

Green R, Bulloch B, Kabani A, Hancock BJ, Tenenbein M

Objectives: The objectives of this study were to determine whether the administration of morphine to children with acute abdominal pain would impede the diagnosis of appendicitis and to determine the efficacy of morphine in relieving the pain.

Key Study: Oxycodone vs placebo in children with undifferentiated abdominal pain: a randomized, double-blind clinical trial of the effect of analgesia on diagnostic accuracy

Visit

Kokki H, Lintula H, Vanamo K, Heiskanen M, Eskelinen M

Objective: To evaluate the effects of buccal oxycodone on pain relief, physical examination findings, diagnostic accuracy, and final clinical outcomes in children with acute abdominal pain.

Key Study: Treatment of pediatric migraine headaches: a randomized, double-blind trial of prochlorperazine versus ketorolac

Visit

Brousseau DC, Duffy SJ, Anderson AC, Linakis JG

Study Objective: We compare the effectiveness of intravenous ketorolac and intravenous prochlorperazine in the treatment of pediatric migraine headaches.

Key Study: The anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations

Visit

White NJ, Kim MK, Brousseau DC, Bergholte J, Hennes H

Objectives: To determine the effectiveness of lidocaine-adrenaline-tetracaine (LAT) in providing adequate anesthesia for the repair of finger lacerations and to monitor the risk of digital ischemia following application of LAT gel to finger lacerations.

Key Study: Emergency department analgesia for fracture pain

Visit

Brown JC, Klein EJ, Lewis CW, Johnston BD, Cummings P

Study Objectives: We analyze records of all emergency department (ED) patients with extremity or clavicular fractures to describe analgesic use, compare analgesia between adults and children, and compare analgesia between the subset of these adults and children with documented moderate or severe pain. Among children, we compare treatment between pediatric and nonpediatric facilities.

Key Study: A randomized clinical trial of analgesia in children with acute abdominal pain

Visit

Kim MK, Strait RT, Sato TT, Hennes HM

Objective: To evaluate the effects of intravenous morphine on pain reduction, physical examination, and diagnostic accuracy in children with acute abdominal pain.

Key Study: The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement

Visit

Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B

The Faces Pain Scale (FPS; Bieri et al., Pain 41 (1990) 139) is a self-report measure used to assess the intensity of children's pain. Three studies were carried out to revise the original scale and validate the adapted version.

Key Study: A prospective randomized pilot comparison of intranasal fentanyl and intramuscular morphine for analgesia in children presenting to the emergency department with clinical fractures

Visit

Younge PA, Nicol MF, Kendall JM, Harrington AP

Objective:To evaluate the tolerability and efficacy of intranasal fentanyl analgesia for children.

Key Study: The FLACC: a behavioral scale for scoring postoperative pain in young children

Visit

Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S

Purpose: To evaluate the reliability and validity of the FLACC Pain Assessment Tool which incorporates five categories of pain behaviors: facial expression; leg movement; activity; cry; and consolability.

Key Study: Reliability and validity of the Faces and Word Descriptor Scales to measure procedural pain

Visit

Keck JF, Gerkensmeyer JE, Joyce BA, Schade JG

Reliability and validity of the Faces and Word Descriptor Scales to measure pain in verbal children undergoing painful procedures were assessed.