Postoperative Pain Management in Children of Hispanic Origin

Abstract

Background It has been established that pain is frequently undertreated in children following outpatient surgery. Very few studies, however, have investigated this phenomenon in ethnically diverse populations. Methods This study included 105 families of children age 2–15 years of Hispanic origin and low income undergoing outpatient tonsillectomy and adenoidectomy surgery. Participating parents completed baseline and demographic packets. Recorded postoperative pain ratings and administration of analgesics at home for one week were collected during home visits. Results Despite the high (70%, 99% CI[57%, 82%]) incidence of significant pain in the first 24 hours home, 32% (95% CI[20%, 45%]) of the children received 0–1 dose of analgesia. Overall, 21% children (99% CI[11%, 35%]) received 4 or less total doses of pain medication over the entire week following surgery. Of the total analgesic doses administered to children in the week following surgery, only 44% (99% CI[40%, 47%]) were in accepted ranges. Conclusions Despite experiencing significant postoperative pain, Hispanic children assessed in this study received suboptimal analgesic therapy at home.

A limited evaluation of the association of race and anesthetic medication administration: A single‐center experience with appendectomies

“…Two studies examined the relationship between parent ethnicity and culture and at‐home administration of analgesia after surgery. In Rosales and colleagues’ study, many Latino parents demonstrated fears about pain medication which predicted lower doses of postoperative analgesics at home; Brown and others showed that Latino children had poor pain control at home after surgery while there was no relationship between Latino parents’ acculturation status and administration of analgesia to their children after day surgery . Another study focused on care in the PACU, and noted that after routine tonsillectomy and adenoidectomy Black children reported higher postoperative pain and required more pain medications, suggesting inter‐individual and inter‐racial variability in opioid requirements .…”

Oral morphine versus ibuprofen administered at home for postoperative orthopedic pain in children: a randomized controlled trial

“…Given the lack of consensus standards for analgesia after pediatric outpatient surgery, suboptimal provision of analgesia 2,9 and growing fears about opioids, there is an urgent need for evidence to guide outpatient analgesic choices for children at discharge. We sought to evaluate whether oral morphine was su perior to ibuprofen for relieving children's pain at home, after minor outpatient orthopedic surgery.…”

Effects of a posttonsillectomy management program using a mobile instant messenger on parents’ knowledge and anxiety, and their children's compliance, bleeding, and pain

“…The difference in children's subjective pain in our study and that in other foreign studies may be explained by the following reasons. First, the children's expression of pain or caregivers’ interpretation of children's pain responses has been reported to vary according to their culture (Brown et al, ; Kristjansdottir et al, ; Liao et al, ). Liao et al () argued that Asians tend to less likely to express their pain symptoms to others and enduring pain, which may lead to inaccurate examination and interpretation of children's pain.…”