Pain is one of the most common complaints expressed by hospital patients and is the main reason they seek medical help. Pain is always subjective, so its severity should be assessed individually for each patient. The main issue with pain management in children is the difficulty involved in evaluating it. Numerous studies have developed tools that would allow for an accurate assessment of the intensity of pain in children in the postoperative period. Adequate postoperative pain assessment in pediatric patients may significantly improve their comfort and quality of life. Postoperative pain prolongs recovery and hospitalization; therefore, the severity of the pain should be part of a routine assessment. Whichever tool is applied to measure pain, it should take into account the child's age, language, ethnicity, and cognitive ability. There is no one universal method for pain assessment which is appropriate for every pediatric patient. This article provides a review of the available subjective methods of postoperative pain assessment, including new objective diagnostic methods and the latest guidelines for postoperative pain therapy in a group of pediatric patients.
The aim of this randomized, controlled trial was to determine whether children undergoing otolaryngological procedures (adenoidectomy, adenotonsillotomy, or tonsillectomy) benefit from pre-emptive analgesia in the postoperative period. Methods: Fifty-five children were assessed for eligibility for the research. Four children refused to participate during the first stage of the study, leaving fifty-one (n = 51) to be randomly assigned either to receive pre-emptive analgesic acetaminophen (15 mg/kg; n = 26) or a placebo (n = 25) in addition to midazolam (0.5 mg/kg) as premedication. All children were anesthetized with sevoflurane, propofol (2–4 mg/kg), and fentanyl (2 mcg/kg). Postoperative pain was assessed using the Visual Analogue Scale (VAS), the Wong–Baker Faces Pain Rating Scale, and the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. The postoperative pain was measured 1, 2, 4, and 6 h after the surgery. Results: The clinical trial reported a statistically significant correlation between administering pre-emptive analgesia (acetaminophen) and reducing pain in children after otolaryngological procedures compared to placebo. The ratio of boys to girls and age were similar among the groups (p > 0.05), so the groups of children were not divided by gender or age. Conclusions: Standard pre-emptive analgesia reduced the severity of pain in the postoperative period after otolaryngological procedures in children. Acetaminophen given before surgery reduces postoperative pain in children undergoing otolaryngological procedures.
Introduction
Pain assessment in children is crucial in managing postoperative analgesia; it is therefore necessary to determine the most accurate tool for assessing pain in children. The aim of this study was to evaluate the correlation between skin conductance measurements and self-reporting pain scales in children after otolaryngology procedures.
Materials and methods
Thirty-three children (N=33) were assessed for eligibility for the research. Postoperative pain was assessed using the Visual Analogue Scale; the Wong-Baker Faces Pain Rating Scale; the Face, Legs, Activity, Cry, and Consolability scale; and a skin conductance algesimeter. The postoperative pain was measured 1 and 2 hours after the surgery.
Results
There was no statistically significant correlation between self-reported pain scores and the skin conductance fluctuations in the children studied, regardless of gender or age. A statistically significant correlation was found between the existing subjective pain scales in children.
Conclusions
The skin conductance measurements do not provide an additional reliable tool for assessing pain in patients after otolaryngological procedures. The existing self-reported pain scales are sufficient to assess postoperative pain in children.
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