Pain relief in children following outpatient surgery

• Published in: Journal of clinical anesthesia Vol. 11; no. 3; pp. 187 - 191
• Main Authors: Munro, Hamish M, Malviya, Shobha, Lauder, Gillian R, Voepel-Lewis, Terri, Tait, Alan R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.1999
• Subjects: Adolescent; Ambulatory Surgical Procedures; Analgesia; Child; Child, Preschool; Female; Humans; Infant; Male; Pain; Pain - drug therapy; Pain Measurement; pediatrics; Postoperative Care - methods; surgery, outpatient; Surveys and Questionnaires; Pain; pediatrics; surgery, outpatient
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/S0952-8180(99)00022-7

Study Objective: To evaluate perioperative analgesia, prescription patterns, pain relief, and parental care of children undergoing outpatient surgery. Design: Prospective data collection and parental interview. Setting: Large tertiary care, university-based medical center. Patients: 471 children aged between 10 months and 18 years who underwent an outpatient surgical procedure expected to be associated with pain. Measurements and Main Results: All perioperative data regarding analgesia, antiemetics, postoperative pain scores, and discharge prescriptions were recorded. Parents were telephoned 24 hours following surgery, and data concerning their child’s pain relief, analgesic and antiemetic usage, and their ability to care for their child were obtained. Of the 460 patients questioned, 97% were described by their parents as having adequate, good, or very good pain relief (acceptable) during the first 24 hours postoperatively, whereas only 15 (3%) had poor pain relief (unacceptable). All patients received some form of analgesia intraoperatively. The children with poor pain relief were more likely to have experienced postoperative nausea and vomiting (p = 0.01) and were more difficult to care for at home (p < 0.0001). In a subset of 185 patients who had genitourinary procedures, those who received regional analgesia reported better pain relief (p = 0.05). Conclusions: Despite a wide range of surgical procedures being performed on children on an ambulatory basis, current selection of patients for outpatient surgery is appropriate given the ability of the parents to manage their children’s pain and to care for their children at home.