Pain prevalence in infants and preschool children in a Colombian hospital

  • José Manuel Quintero-Castellanos a. Pain Unit, Hospital San Rafael de Tunja. Tunja, Colombia. b. Research Postgraduate Program, Universidad Pedagógica y Tecnológica de Colombia. Tunja, Colombia.
  • Ángela Hernández Pain Unit, Hospital San Rafael de Tunja. Tunja, Colombia.
  • Tania Parra Research Postgraduate Program, Universidad Pedagógica y Tecnológica de Colombia. Tunja, Colombia.
Keywords: Pain, Prevalence, Infant, Child, Preschool, Pain Measurement


Introduction: The pain prevalence in hospitalized infants and preschool children has not been accurately identified in high-income countries, and in low and medium-income countries it has not been extensively studied. The assessment instruments are limited.

Objective: To describe the prevalence and management of pain in infants and preschool children during the first 24 hours of hospitalization in a third level institution in Colombia, using the CRIES scale.

Methods: An observational study was conducted during the first 24 hours of hospitalization. Demographic information was recorded, pain was assessed at admission, after 4, and 24 hours using the CRIES scale. Pharmacological therapy was also documented.

Results: 250 children between one month and 5 years old were studied. The pain prevalence at admission was 12 %. The pain prevalence per subgroups was higher among the surgical patients, as compared to the clinical patients (35.9 % vs. 7.6 %). The pharmacological analysis revealed that 70.8 % of patients received treatment; the most widely used medications were oral acetaminophen and intravenous dipyrone.

Conclusions: Pain prevalence was lower than the levels described for the general pediatric population. This result may be due to the sensitivity of the CRIES instrument, or to a particular pain behavior. Further studies are needed to identify the sensitivity of the assessment instruments in early life and to accurately investigate any associated phenomena.


IASP. Pain terms a current list with definitions and notes on usage. Pain. 1986;24:S215-21. doi:

Aydede M. Does the IASP definition of pain need updating? Pain Reports. 2019;4(5):1-7. doi:

Friedrichsdorf SJ, Goubert L. Pediatric pain treatment and prevention for hospitalized children. PAIN Reports. 2020;5(1):e804. doi:

Shomaker K, Dutton S, Mark M. Pain prevalence and treatment patterns in a us children’s hospital. Hosp Pediatr. 2015;5(7):363-70. doi:

Twycross A, Collis S. How well is acute pain in children managed? A snapshot in one english hospital. Pain Manag Nurs. 2013;14(4):e204-15. doi:

Walther-Larsen S, Pedersen MT, Friis SM, et al. Pain prevalence in hospitalized children: a prospective cross-sectional survey in four Danish university hospitals. Acta Anaesthesiol Scand. 2017;61(3):328-37. doi:

Vejzovic V, Bozic J, Panova G, Babajic M, Bramhagen AC. Children still experience pain during hospital stay: A cross-sectional study from four countries in Europe. BMC Pediatr. 2020;20(1):4-9. doi:

Friedrichsdorf SJ, Postier A, Eull D, et al. Pain outcomes in a US children’s hospital: A prospective cross-sectional survey. Hosp Pediatr. 2015;5(1):18-26. doi:

Taylor EM, Boyer K, Campbell FA. Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Res Manag. 2008;13(1):25-32. doi:

Birnie KA, Chambers CT, Fernandez CV., et al. Hospitalized children continue to report undertreated and preventable pain. Pain Res Manag. 2014;19(4):198-204. doi:

Cummings EA, Reid GJ, Finley GA, McGrath PJ, Ritchie JA. Prevalence and source of pain in pediatric inpatients. Pain. 1996;68(1):25-31. doi:

Merkel SI, Voepel-Lewis TSJ, Malviya S. The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-7.

Reinoso-Barbero F, Lahoz Ramn AI, Durn Fuente MP, Campo Garca G, Castro Parga LE. Escala LLANTO: Instrumento español de medición del dolor agudo en la edad preescolar. An Pediatr. 2011;74(1):10-4. doi:

Tibaduiza D, Ulloa LC, López CA, Rodríguez Torres V. Evaluación de la validez de la escala llanto para dolor en neonatos y menores de cinco años. [Internt]. [Citado 17 Nov 2020]. Disponible en:

Goodman JE, McGrath P. The epidemiology of pain in children and adolescents: a review. Pain. 1991;46(3):247-64. doi:

American Academy of Pediatrics. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics. 2001;108(3):793-7. doi:

Ellis JA, O’Connor BV, Cappelli M, Goodman JT, Blouin R, Reid CW. Pain in hospitalized pediatric patients: How are we doing? Clin J Pain. 2002;18(4):262-9. doi:

Manworren RC, Stinson J. Seminars in pediatric neurology pediatric pain measurement, assessment and evaluation. Nurs Chair Child Heal Nurse Pract. 2017;23(3):189-200. doi:

Snidvongs S, Nagaratnam M, Stephens R. Assessment and treatment of pain in children. Br J Hosp Med. 2008;69(4):211-3. doi:

Ghai B, Makkar JK, Wig J. Postoperative pain assessment in preverbal children and children with cognitive impairment. Paediatr Anaesth. 2008;18(6):462-77. doi:

Brattberg G. Do pain problems in young school children persist into early adulthood? A 13-year follow-up. Eur J Pain. 2004;8(3):187-99. doi:

Victoria NC, Murphy AZ. Exposure to early life pain: Long term consequences and contributing mechanisms. Curr Opin Behav Sci. 2016;7(2015):61-8. doi:

Williams MD, Lascelles BDX. Early neonatal pain-a review of clinical and experimental implications on painful conditions later in life. Front Pediatr. 2020;8:30. doi:

Bawa M, Mahajan JK, Aggerwal N, Sundaram J, Rao KLN. Barriers to pediatric pain management in children undergoing surgery: A survey of health care providers. J Pain Palliat Care Pharmacother. 2015;29(4):353-8. doi:

Schlegelmilch M, Punja S, Jou H, et al. Observational study of pediatric inpatient pain, nausea/vomiting and anxiety. Children. 2019;6(5):65. doi:

Torio C. Paediatric pain-related conditions impact healthcare expenditures. Evid Based Med. 2015;20(6):229. doi:

DANE. Estimaciones de Población 2005-2017 Departamentos [internet]. 2017 [citado 2020 jun. 20]. Disponible en:

Doca FNP, Costa ÁL, Finley GA, Linhares MBM. Pain in pediatric inpatients: Prevalence, characteristics, and management. Psychol Neurosci. 2017;10(4):394-403. doi:

Wong DL, Baker C. Pain in children: Comparison of assessment scales. Pediatr Nurs. 1988;14(1):9-17. doi:

Harrison D, Joly C, Chretien C, et al. Pain prevalence in a pediatric hospital: Raising awareness during Pain Awareness Week. Pain Res Manag. 2014;19(1):24-30. doi:

Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the face, legs, activity, cry and consolability scale for assessing pain in infants and children: Is it reliable, valid, and feasible for use? Pain. 2015;156(11):2132-51. doi:

Suraseranivongse S, Santawat U, Kraiprasit K, Petcharatana S, Prakkamodom S, Muntraporn N. Cross-validation of a composite pain scale for preschool children within 24 hours of surgery. Br J Anaesth. 2001;87(3):400-5. doi:

Thrane SE, Wanless S, Cohen SM, Danford CA. The assessment and non-pharmacologic treatment of procedural pain from infancy to school age through a developmental lens: A synthesis of evidence with recommendations. J Pediatr Nurs. 2016;31(1):e23-32. doi:

Velázquez C, Rajah C, Nosisi Y, Joerg S. An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital. Pain Reports. 2019;4(6):1-7. doi:

Kozlowski LJ, Kost-Byerly S, Colantuoni E, et al. Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Manag Nurs. 2014;15(1):22-35. doi:

Linhares MBM, Doca FNP, Martínez FE, et al. Pediatric pain: Prevalence, assessment, and management in a teaching hospital. Brazilian J Med Biol Res. 2012;45(12):1287-94. doi:

Stevens BJ, Harrison D, Rashotte J, et al. Pain assessment and intensity in hospitalized children in Canada. J Pain. 2012;13(9):857-65. doi:

Stevens BJ, Abbott LK, Yamada J, et al. Epidemiology and management of painful procedures in children in Canadian hospitals. CMAJ. 2011;183(7):403-10. doi:

Stinson J, Yamada J, Dickson A, Lamba J, Stevens B. Review of systematic reviews on acute procedural pain in children in the hospital setting. Pain Res Manag. 2008;13(1):51-7. doi:

King S, Chambers CT, Huguet A, et al. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain. 2011;152(12):2729-38. doi:

Lynch AM, Kashikar-Zuck S, Goldschneider KR, Jones BA. Sex and age differences in coping styles among children with chronic pain. J Pain Symptom Manage. 2007;33(2):208-16. doi:

Batoz H, Semjen F, Bordes-Demolis M, Bnard A, Nouette-Gaulain K. Chronic postsurgical pain in children: Prevalence and risk factors. A prospective observational study. Br J Anaesth. 2016;117(4):489-96. doi:

Shah P, Siu A. Considerations for neonatal and pediatric pain management. Am J Heal Pharm. 2019;76(19):1511-20. doi:

de Leeuw TG, Dirckx M, González Candel A, Scoones GP, Huygen FJPM, de Wildt SN. The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review. Paediatr Anaesth. 2017;27(12):1193-201. doi:

Fieler M, Eich C, Becke K, et al. Metamizole for postoperative pain therapy in 1177 children: A prospective, multicentre, observational, postauthorisation safety study. Eur J Anaesthesiol. 2015;32(12):839-43. doi:

Stamer UM, Stammschulte T, Erlenwein J, et al. Recommendations for the perioperative use of dipyrone: Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine. Schmerz. 2019;33(4):287-94. doi:

Souki M. Metamizole for postoperative pain therapy. Eur J Anaesthesiol. 2016;33(10):785-6. doi:

Messerer B, Grögl G, Stromer W, Jaksch W. Perioperative systemische schmerztherapie bei kindern. Österreichische interdisziplinäre handlungsempfehlungen zum perioperativen schmerzmanagement bei kindern. Schmerz. 2014;28(1):43-64. doi:

García M, Funes R, Vidal A. Manejo del dolor en Atención Primaria. AEPap (ed) Curso Actual Pediatría. 2016;(3):379-90.

Carlson J, Youngblood R, Dalton JA, Blau W, Lindley C. Is patient satisfaction a legitimate outcome of pain management? J Pain Symptom Manage. 2003;25(3):264-75. doi:

Schwenkglenks M, Gerbershagen HJ, Taylor RS, et al. Correlates of satisfaction with pain treatment in the acute postoperative period : Results from the international PAIN OUT registry. Pain. 2014;155(7):1401-11. doi:

Andrews RM, Browne AL, Wood F, Schug SA. Predictors of patient satisfaction with pain management and improvement 3 months after burn injury. J Burn Care Res. 2012;33(3):442-52. doi:

How to Cite
Quintero-Castellanos JM, Hernández Ángela, Parra T. Pain prevalence in infants and preschool children in a Colombian hospital . Colomb. J. Anesthesiol. [Internet]. 2021 Sep. 2 [cited 2024 May 30];50(1). Available from:


Download data is not yet available.
How to Cite
Quintero-Castellanos JM, Hernández Ángela, Parra T. Pain prevalence in infants and preschool children in a Colombian hospital . Colomb. J. Anesthesiol. [Internet]. 2021 Sep. 2 [cited 2024 May 30];50(1). Available from:


Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: