CP: Assessment, Pain Relief (AACPDM Report)

Subject: CP: Assessment, Pain Relief (AACPDM Report)

Date: 9/20/2002

E-MOVE reports from the 56th Annual Meeting of the American Academy of Cerebral Palsy and Developmental Medicine, held in New Orleans September 11-14 2002. Session numbers and pages refer to abstracts published in Developmental Medicine and Child Neurology 2002;44(supplement 91).

1. Blind video rating of GMFM assessments in children with cerebral palsy is not required to eliminate scoring bias
AL Fosang, P Thomason, JA King, AT McCoy, GJ Coleman, HK Graham, DS Reddihough
SP29; 44

Results from unblinded assessment of the Gross Motor Function Measure agree with those from blinded assessment, according to this report.

Five physical therapists (two blinded, three unblinded) trained in administering the GMFM rated gross motor function via videotape at three time points over 12 months in 49 children with CP of varying severity. Concordance correlation coefficient was 0.78-0.89 for the lying dimension of the measure, and was at least 0.91 for all other dimensions. The authors conclude that in the context of intervention trials, blinded videotape rating is not required to avoid bias.

2. Intravenous patient-controlled analgesia for post-operative pain management following orthopaedic surgery in patients with cerebral palsy
CY Chung, WJ Yoon, HS Kim
SP36; 47

Patients can safely and effectively control their own pain following orthopedic surgery, according to this study.

Sixty patients with CP (ages 5-15) received either minor procedures (soft tissue release or tendon transfer) or major procedures (osteotomy followed by soft tissue procedure). Sixteen minor and 14 major surgery patients received intravenous fentanyl citrate and ketorolac tromethamine, delivered continuously at a basal rate with patient-controlled bolus injection as needed, with a minimum of 15 minutes between injections. All other patients received standard IV pethedine as needed, with a minimum injection interval of at least 4 hours. Pain intensity was assessed from two hours to three days postoperatively. The sum of the pain scores was significantly less for patients with self-controlled analgesia who underwent major, but not minor, procedures. Side effects were rare and similar between the two groups.

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2002 E-MOVE conference reports are made possible in part through unrestricted educational grants from Elan Pharmaceuticals, Glaxo SmithKline, and Pharmacia Corporation.

E-MOVE Editor: Richard Robinson, NASW, WE MOVE

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