Pediatrik Hastalarda Postoperatif Dönemde Ağrı ve Deliryumu Ayırt Etmede FLACC ve OPS Ölçeklerinin Karşılaştırılması

Amaç: Postoperatif ağrı ve pediyatrik deliryum (ED) postoperatif erken dönem negatif davranışlarıdır. Ancak birbirinden ayırt etmek çok zordur. Bu çalışmanın amacı, postoperatif erken dönemde ağrıyı ve ED'yi ayırmada FLACC ve OPS ölçeğinin kullanılabilirliğini karşılaştırmaktır. Materyal ve Metot: Bu prospektif çalışma bir üniversite hastanesinde yürütülmüştür. Altmış bir (61) çocuk çalışmaya dâhil edilmiştir. Tüm çocuklara genel anestezi uygulanmıştır. ED insidansı PAED skalası ile ağrı insidansı postoperatif dönemde hem FLACC hem de OPS skalaları ile değerlendirilmiştir. Bulgular: En az bir değerlendirme zamanında, sadece deliryumlu çocuk sayısı 29 (%47,5), ağrısı olan çocuk sayısı 10 (%16,4) ve hem deliryum hem de ağrısı olan çocuk sayısı 25 (%40,9) idi. FLACC için 5. dakikada eğrinin altındaki alan (AUC = 0.914, P = 0.02) ve 15. dakikada eğrinin altındaki alan (AUC = 0.865, P <0.001) yüksekti. Sonuç: FLACC' in pediyatrik hastalarda postoperatif dönemde ağrı ve deliryumu ayırt etmede kullanılabilirlği OPS'dan daha iyidir.

Anahtar Kelimeler:

ağrı, FLACC skalası, OPS skalası, PAED skalası, deliryum

The Comparison of FLACC and OPS Scales in Differentiating Pain and Emergence Delirium in the Postoperative Period in Pediatric Patients

Objective: Postoperative pain and pediatric emergence delirium (ED) are early-postoperative negative behaviours. However it is very difficult to diferentiate each other. The aim of the present study is to compare the utility of “Face, legs, Activity, Cry, Consolability” (FLACC) and Objective Pain Scale (OPS) in differentiating the pain and ED in the early postoperative period. Materials and Methods: This prospective study was conducted at a university hospital. Sixty one (61) children were included in this study. General anesthesia was provided for all children. The incidence of ED was evaluated with PAED scale, the incidence of pain was evaluated with both FLACC and OPS scales in the early postoperative period. Results: Only the number of children with delirium were 29 (47.5%), with pain were 10 (16.4%) and with both delirium and pain were 25 (40.9%). For FLACC, the area under the curve (AUC = 0.914, p = 0.02) at the 5th minute and the area under the curve value (AUC = 0.865, p < 0.001) at the 15th minute was high. Conclusions: The utility of FLACC is better than OPS in differentiating pain and emergence delirium in the postoperative period in pediatric patients.

Keywords:

Pain, delirium, FLACC scale, OPS scale, PAED scale,

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