Postoperative pain in small-for-gestational age infants after hernia repair, orchidopexy and urethral reconstruction surgery: A pilot study

Early Hum Dev. 2019 Sep:136:39-44. doi: 10.1016/j.earlhumdev.2019.07.003. Epub 2019 Jul 11.

Abstract

Background: Small-for-gestational-age (SGA) birth bears an enhanced risk of developing hypertension, obesity, insulin resistance and mental health disorders in later life as a consequence of adaptive processes in utero. Only a small number of studies on pain perception in SGA infants exist. These are indicative of a blunted stress response to pain in SGA newborns.

Aim: We initiated a pilot study investigating differences in postoperative pain perception between SGA and appropriate-for-gestational-age (AGA) infants.

Methods: Pain and alertness levels of 10 formerly SGA and 14 AGA infants at the age 0.5-2 years were evaluated by the FLACC scale, Steward and Aldrete Scores following hernia repair, reconstructive surgery of hypospadia and orchidopexy. In addition, the postoperative consumption of non-steroidal anti-inflammatory drugs was compared between SGA and AGA.

Results: Postoperative pain and alertness levels were not significantly different in SGA and AGA children. We did not observe significant group differences regarding the consumption of non-steroidal anti-inflammatory drugs.

Conclusion: While previous studies were suggestive of a suppressed stress response to pain in SGA newborns, these findings did not fully translate into an altered response to pain beyond the newborn age. Further studies in a larger cohort seem necessary to verify this finding.

MeSH terms

  • Female
  • Herniorrhaphy / adverse effects*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Male
  • Orchiopexy / adverse effects*
  • Pain / epidemiology*
  • Pain / etiology
  • Pilot Projects
  • Plastic Surgery Procedures / adverse effects*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Urethra / surgery*