2009 Southern Regional Meeting Abstracts

Purpose of Study: Accurate tools for assessing pain are critical for developing and evaluating pain control techniques. Videotape review has been utilized in the analysis and comparison of pain measures in children. However, there is little data in children about the accuracy and reliability of videotape review pain scoring. The objective of this study was to assess the validity of videotape review as a tool for evaluating the pain of peripheral intravenous catheterization (PIVC) experienced by children.
Methods Used: A convenience setting of 68 children in the emergency department of an urban, tertiary care hospital were enrolled in this prospective, observational, double-blind trial. Three blinded physicians independently reviewed videotapes of patients undergoing PIVC insertion. Each observer rated the patients’ pain based on videotape review by assigning a visual analogue scale (VAS) score. The observers were blinded to the type of anesthesia administered to each patient prior to the procedure as well as to the patients’ self-report VAS scores. The observers’ VAS scores were compared with the patients’ VAS scores for the same procedure. The three observers’ scores were also compared with one another to determine reproducibility of VAS scores after videotape review.
Summary of Results: Using Spearman’s rho, weak to moderate correlation was demonstrated between the physician observers’ VAS scores and the patients’ self-reported VAS scores with Spearman’s rho of 0.412-0.504. Moderate correlation was demonstrated among the blinded observers’ VAS scores with Spearman’s rho of 0.517 - 0.837. Interclass correlation coefficients for the physician observers were 0.492 - 0.602.
Conclusions: Videotape review of children’s pain while undergoing PIVC placement did not accurately measure pain. Patient self-report of pain may still be the best measurement of patient pain.