International Initiatives Extending Safe Anesthesia Practice: Improving Pediatric Postsurgical Pain in Low-to-Middle-Income-Countries

Abstract

Purpose. This project aimed to improve low-to-middle-income country provider knowledge and competence concerning the pathophysiology and assessment of pain via web-based education at Lao Friends Hospital for Children in Luang Prabang, Laos.Background. The surgical burden is increasingly prevalent for pediatric patients in low-to-middle-income countries. Pediatric pain is misunderstood and undertreated to a greater degree in developing countries due to a historical lack of formal pain education and cultural barriers. As global priorities continue to shift towards surgical intervention, addressing barriers to effective pediatric pain management are necessary to negate the maladaptive physiologic and psychologic consequences of unrelieved postsurgical pain. Methods. Physician, nurse, and healthcare administrative affiliated participants viewed two personalized web-based educational presentations on pain pathophysiology and pain assessment. To measure knowledge improvement, a post-pre-survey was completed after the presentations. The post-pre-survey was used to evaluate the effectiveness of the educational interventions by assessing the participants’ change in knowledge. Results. Ten participants affiliated with Lao Friends Hospital for Children completed the post-pre-survey with a response rate of 77%. A statistically significant improvement in knowledge by 28.5% was found. The most considerable improvement in knowledge found was regarding rebound pain at 45%. Participants also reported an increased ability to confidently use pediatric pain scales for pain assessment and teach about the pathophysiology and assessment of pain. Conclusions. This evidence supports web-based education as an effective means to improve low-to-middle-income-country provider knowledge about pain pathophysiology and pain assessment. Future research will assess this evidence-based educational intervention’s ability to improve pediatric postsurgical pain and patient outcomes.