Doctors from Nice have developed an app to study postoperative pain in children

How are children returning home after surgery? With the necessary generalization of ambulatory practices, the issue of the pain of young patients, once they return home, is a subject of medical concern. The specificity of pediatrics and the contribution of new technologies now make it possible to provide a complementary analysis rich with lessons.

To better assess the duration and intensity of the pain, three doctors from Nice, Dr. Communicate with families via the Link4Life app during the 10 days following the operation. Link4Life was already founded in 2016 by doctors, and it is being developed with the support of the Alpes-Maritimes Board of Directors and the Lenval Foundation, allowing this study to be launched in 2019.

“We decided to improve the exchange between health professionals and families through a mobile application. This tool allows great interaction and is the subject of research work in order to improve care in surgery.Explains Dr. Francois de la Briere, Head of the Department of Anesthesia at Children’s Hospitals Nice CHU – Lenval. To obtain a representative committee necessary to carry out our work, we contacted other pediatric institutions via ADARPEF (Association des Anesthésistes-Réanimateurs Pédiatriques d’Expression Française, editor’s note). Twelve centers participated and nearly 800 parents used the app.”

Very concretely, upon leaving the hospital, families were invited to download Link4life (for free). Enter the required data (temperature, nausea, medication intake, etc.) into the program. Depending on the answers, the algorithm can trigger an alert to caregivers (eg in the event of an abnormal parameter) and at the same time provide advice to parents (sort of “You can give a pain reliever”). This fulfills a dual need: for caregivers to know how the young patient is doing and the parents’ need to “watch”.

The child cannot express the pain

The research team looked at factors that might explain why there was more pain after surgery. Among those age. “Actually, it is related to the ability to articulate. When parents evaluate it, the pain is less than when it is young children who are expressing themselves. A 0-2-year-old can’t pronounce it, a 2-year-old child And 4 years old expresses a very special feeling (it is “not bad” or “very bad”), a child of 4-6 years old can express the nuances: little, average, a lot. ”

“After 6 years, we can consider that they know how to express their feelings and rate them from 0 to 10, as prescribed by the doctor. In addition, we have noticed that certain types of surgery, especially visceral, hurt more.” and Dr. de la Briere to determine it “The work has highlighted the fact that the experience is more painful in anxious families. So we can again imagine adapting certain practices to this factor.”

Advice is delivered via the app

Other indications indicated by Link4Life include nausea and vomiting in 10% of patients. Families don’t always know what to do, but it is possible to guide them by giving them simple tips, via notifications in the app, such as giving sugar water, popsicles or even anti-inflammatories. Which reduces these symptoms and thus improves the Prism – Practical Experience.

This study was published in the famous journal bread. “We must take into account in medical practices a personal and pragmatic approach, and strong in this observation, by continuing to develop tools that are adapted to children under 6 years of age. This is our ambition today, and it is a pediatric pain scale integrated into a tool that facilitates interactions,” he explains. This project tangibly demonstrates the importance of pediatric research funding.”

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