Opiate analgesics and testing of post traumatic amnesia in school-aged children

ABSTRACT

Objective

To assess the validity of the Westmead PTA scale in school-aged children treated with opiate analgesics.

Method

Twenty-eight hospitalized children without brain injury, aged between 8 and 16 years treated with opiate analgesics for pain relief following surgery were tested on the Westmead PTA scale. Pain and stress levels were also self-reported each day.

Results

Only 29% (n = 7) of children assessed over four days obtained a maximum score of 12/12 on three consecutive days, thus 71% would have been deemed to have been in PTA when they were not. The percentage of children who obtained a maximum score significantly decreased over consecutive days of assessment, due to an increase in error rate on picture memory items. Self-reported pain and stress ratings were not correlated with PTA scores.

Conclusions

Opiate analgesia can disrupt performance on the Westmead PTA scale in school-aged children resulting in a high false-positive error rate. It is therefore important to record pain medication schedules and interpret results cautiously when opiate analgesia is used following a TBI. Alteration of the method of administration of the memory items should be researched as this may increase the validity of the scale for children with TBI treated with opiate analgesics.

KEYWORDS:

• PTA assessment
• traumatic brain injury
• pediatric

Acknowledgments

We would like to thank the participants and their families for taking part in the project during their inpatient stay and also the CNC from the Pain Team and the CNC from the Trauma Service for their support.

Disclosure of interest

The authors report no conflict of interest. This work was support by a Sydney Children’s Hospital Foundation Seed Funding Grant.

Data access statement

The authors confirm that the data supporting the findings of this study are available within the article and/or its supplementary materials.

Additional information

Funding

This work was supported by the Sydney Children’s Hospital Foundation.