Anästhesiol Intensivmed Notfallmed Schmerzther 2010; 45(9): 592-594
DOI: 10.1055/s-0030-1265752

© Georg Thieme Verlag Stuttgart · New York

QUIPSI – Qualitätsverbesserung der postoperativen Schmerztherapie bei Kindern

Quality improvement of postoperative pain management in infants QUIPSI) – A pilot studyBrigitte Messerer, Annelie Martina Weinberg, Andreas Sandner-Kiesling, Anton Gutmann, Swantje Mescha, Winfried Meissner
Further Information

Publication History

Publication Date:
13 September 2010 (online)


Bei Erwachsenen ist die Erhebung der Ergebnisqualität zur Analyse der postopüerativen Schmerzmanagmentes nach Operationen zunehmend Standard. In diesem Pilotprojekt wurde erstmals versucht dies auch bei Kindern durchzuführen (QUIPSI). Es konnte gezeigt werden, dass die Ergebnisqualität der postoperativen Schmerztherapie bei Kindern nach Operationen gemessen und in die tägliche Routine integriert werden kann. QIPSI (Quality Improvement in Postoperative Pain Management in Infants) ist ein neues Tool zur Überprüfung der Ergebnis- und Prozessqualität des postoperativen Schmerzmanagementes im Kindesalter nach Operationen. In einem nächsten Schritt wird an 10 Kliniken eine multizentrische Erhebung zur Machbarkeit durchgeführt.


Outcome-focussed benchmarking has been shown to be a successful tool in adult quality improvement of postoperative pain management in adults. We report on feasibility and first results of a similar project in operated children (quality improvement of postoperative pain management in infants, QUIPSI).

Our results show that outcomes in postoperative pain management can be measured and compared in routine clinical practice. QUIPSI (Quality Improvement in Postoperative Pain Management in Infants) represents a new tool for outcome evaluation, consisting of standardized data acquisition of outcome and process quality indicators. In the currently starting second phase of the project, a multicenter evaluation will take place in ten medical centres.

Weiteres Material zum Artikel


  • 1 Bennett-Branson S, Craig K. Postoperative pain in children: developmental and family influences on spontaneous coping strategies.  Can J Behav Sci. 1993;  25 355-383
  • 2 Blount R, Davis N, Powers S, Roberts M. The influence of environmental factors and coping style on children's coping and distress.  Clin Psychol Rev. 1991;  11 93-116
  • 3 Chambers C, Craig K, Bennett S. The impact of maternal behaviour on children's pain experiences: an experimental analysis.  J Pediatr Psychol. 2002;  27 293-301
  • 4 Schanberg L, Keefe F, Lefebvre J. Social context of pain in children with juvenile primary fibromyalgia syndrome: parental pain history and family environment.  Clin J Pain. 1998;  14 107-115
  • 5 Stamer UM, Mpasios N, Maier C, Stuber F. Postoperative analgesia in children – current practice in Germany.  Eur J Pain. 2005;  9 550-560
  • 6 Schoeffel D, Crasser HR, Bach M et al.. Risk assessment in pain therapy.  Schmerz. 2008;  22 594-603
  • 7 Walker SM. Pain in children: recent advances and ongoing challenges.  Br J Anaest. 2008;  101 101-110
  • 8 Lönnqvist PA, Morton NS. Postoperative analgesia in infants and children.  Br J Anaesth. 2005;  95 59-68
  • 9 Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right.  Anesth analg. 2007;  105 205-221
  • 10 Kehlet H, Dahl JB. The value of”multimodal” or “balanced analgesia” in postoperative pain treatment.  Anesth Analg. 1993;  77 1048-1056
  • 11 Grass JA. Patient controlled analgesia.  Anesth Analg. 2005;  101 44-61
  • 12 Duarte LT, Fernandes C Mdo et al.. The incidence of postoperative respiratory depression in patients undergoing intraveous or epidural analgesia with opioids.  Rev Bras Anesthesiol. 2009;  59 409-420
  • 13 Hudcova J, McNicol E, Quah C et al.. Patient controlles intravenous opioid analgesia versus conventional opioid analgesis for postoperative pain control:a quantitative systematic review.  Acute Pain. 2005;  7 115-132
  • 14 Birmingham PK, Suresh S, Rae BR et al.. Patient-Controlled Epidural Analgesia in Children: Can They Do It?.  Anesth Analg. 2003;  96 686-691
  • 15 Moiniche S, Mikkelsen S, Wetterslev J et al.. A qualitative systemic review of incisional local anesthesia for postoperative pain relif after abdominal operations.  Br J Anaesth. 1998;  81 377-383
  • 16 Cnar SO, Kum U, Cevizci N et al.. Effects of levobupivacaine infiltration on postoperative analgesia and stress response in children following inguinal repair.  Eur J Anaesthesiol. 2009;  26 430-434
  • 17 Lönnqvist PA, Morton NS. Postoperative analgesia in infants and children.  Br J Anaesth. 2005;  95 59-68
  • 18 Brodner G et al.. Acute pain management: analysis, implications and consequences after prospective experience with 6349 surgical patients.  Eur J Anaesthesiol. 2000;  17 566-575
  • 19 Richman MJ et al.. Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis.  Anesth Analg. 2006;  102 248-257
  • 20 Gille J, Gille M, Gahr R et al.. Acute pain management in proximal femoral fractures. Femoral nerve block (catheter technique) vs. systemic pain therapy using a clinic internal organisation model.  Anaesthesist. 2006;  55 414-422
  • 21 Schöps P, Seeger D. Physiomedical therapy of acute and chronic pain.  Schmerz. 2009;  23 191-212
  • 22 Howard R, Carter B, Curry J. Quick reference summery of recommendations and good practice points.  Pediatr Anesthesia. 2008;  18 (S 01) 4-13
  • 23 Franck LS, Greenberg CS, Stevens B. Pain assessment in infants and children.  Pediatr Clin North Am. 2000;  47 487-512
  • 24 Treadwell MJ, Franck LS, Vichinsky E. Using quality improvement strategies to enhance pediatric pain assessment.  Int J Qual Health Care. 2002;  14 39-47
  • 25 Suraseranivongse S, Kaosaard R, Intakong P et al.. A comparison of postoperative pain scales in neonates.  Br J Anaesth. 2006;  97 540-544
  • 26 von Baeyer C, Spagrud L. Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years.  Pain. 2007;  127 143-157
  • 27 Mathew PJ, Mathew JL. Assessment and management of pain in infants.  Postgrad Med J. 2003;  79 438-443
  • 28 von Baeyer CL. Children's self-report of pain intensity: scale selection, limitation and interpretation.  Pain Res Manag. 2006;  11 157-162
  • 29 Harmer M, Davies KA. The effect of education, assessment and a standardised prescription on postoperative pain management. The value of clinical audit in the establishment of acute pain services.  Anaesthesia. 1998;  53 424-430
  • 30 Reichl S, Pogatzki-Zahn E. Concepts for perioperative pain therapy. A critical stocktaking.  Anaesthesist. 2009;  58 914-930
  • 31 Saur P, Junker U, Gaus P et al.. Implementation of a standardized perioperative pain management concept in three hospitals of a consortium.  Schmerz. 2008;  33 34-42
  • 32 Brodner G, Mertes N, Buerkle H, Marcus MA, Van Aken H. Acute pain management in Europe: a 17-nation surveyof 105 hospitals. The Euro Pain Acute Pain Working Party.  Eur J Anaesthesiol. 1998;  15 354-363
  • 33 Wiebalck A, Vandermeulen E, Van Aken H, Vandermeersch E. Ein Konzept zur Verbesserung der postoperativen Schmerzbehandlung.  Anaesthesist. 1995;  44 831-842
  • 34 Rawal N, Berggren L. Organization of acute pain service: A low cost model.  Pain. 1994;  57 117-123
  • 35 Meissner W, Ullrich K, Zwacka S. Benchmarking as a tool of continuous quality improvement in postoperative pain management.  Eur J Anaesthesiol. 2006;  23 142-148
  • 36 Meissner W, Mescha S, Rothaug J, Zwacka S, Göttermann A, Ulrich K, Schleppers A. Qualitätsverbesserung der postoperativen Schmerztherapie – Ergebnisse des QUIPS Projektes.  Dt Arztbl. 2008;  105 865-870
  • 37 Benchmarking im Gesundheitswesen – Verbesserung der postoperativen Schmerztherapie durch Einführung eines kontinuierlichen Benchmarkingprozesses.
  • 38 Hicks CL et al.. The faces pain scale-revised: toward a common metric in pediatric pain measurement.  Pain. 2001;  93 173-183
  • 39 Stanford EA, Chambers CT, Craig KD. A normative analysis of the development of pain-related vocabulary in children.  Pain. 2005;  114 278-284
  • 40 Champion GD, Goodenough B, Wu E et al.. Children's self report of pain intensity using six different scale types. Paper presented at the Seventh Internationel Symposium on Pediatric pain 2000, June, London. 
  • 41 Chambers CT, Giesberg K, Craig KD et al.. A comparison of faces scales for the measurement of pediatric pain: children's and parents' ratings.  Pain. 1999;  83 25-35

Dr. med. Brigitte Messerer
Prof. Dr. med. Annelie Martina Weinberg
Prof. Dr. med. Andreas Sandner-Kiesling
Dr. med. Anton Gutmann
Dr. med. Swantje Mescha
PD Dr. med. Winfried Meissner