Published online September 7, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. e588-e595 (doi:10.1542/peds.2008-3529)
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ARTICLE

Pediatric Pain After Ambulatory Surgery: Where's the Medication?

Michelle A. Fortier, PhDa,b, Jill E. MacLaren, PhDa, Sarah R. Martin, MAa, Danielle Perret-Karimi, MDa and Zeev N. Kain, MD, MBAa,c

a Department of Anesthesiology and Perioperative Care, University of California, Irvine, California
b Departments of Pediatric Psychology
c Pediatrics, Children's Hospital of Orange County, Orange, California

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.

Key Words: postoperative pain • pediatric pain • surgery • analgesia • pain management

Abbreviations: GCRC—General Clinical Research Center • VAS—visual analog scale • PPPM—Parents' Postoperative Pain Measure • STAI—State-Trait Anxiety Inventory • MBSS—Miller Behavioral Style Scale • EASI—Emotionality, Activity, Sociability, and Impulsivity Temperament Survey • mYPAS—Modified Yale Preoperative Anxiety Scale

Accepted May 29, 2009.


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