Pediatric pain after ambulatory surgery: where's the medication?

Pediatrics. 2009 Oct;124(4):e588-95. doi: 10.1542/peds.2008-3529. Epub 2009 Sep 7.

Abstract

Objective: The purpose of this controlled study was to provide a description of children's postoperative pain, including pain intensity and analgesic consumption.

Methods: Participants included 261 children, 2 to 12 years of age, undergoing routine tonsillectomy and adenoidectomy surgery. Baseline and demographic data were collected before surgery, and a standardized approach to anesthesia and surgical procedures was used. Pain and analgesic consumption were recorded for 2 weeks at home.

Results: On the first day at home, although parents rated 86% of children as experiencing significant overall pain, 24% of children received 0 or just 1 medication dose throughout the entire day. On day 3 after surgery, although 67% of children were rated by parents as experiencing significant overall pain, 41% received 0 or 1 medication dose throughout the entire day.

Conclusions: We conclude that a large proportion of children receive little analgesic medication after surgery and research efforts should be directed to the discrepancy between high ratings of postoperative pain provided by parents and the low dosing of analgesics they use for their children.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenoidectomy / adverse effects
  • Adenoidectomy / methods
  • Age Factors
  • Ambulatory Surgical Procedures / adverse effects*
  • Analgesia / standards*
  • Analgesia / trends
  • Analgesics / therapeutic use*
  • Analgesics, Opioid / therapeutic use
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pain Measurement
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Pediatrics / standards
  • Pediatrics / trends
  • Postoperative Care / methods
  • Preoperative Care / methods
  • Probability
  • Tonsillectomy / adverse effects
  • Tonsillectomy / methods
  • Treatment Outcome

Substances

  • Analgesics
  • Analgesics, Opioid