A survey of postoperative pain treatment in children of 3–14 years

Abstract

There is a lack of information concerning the characteristics of pediatric postoperative pain in Southern European countries. The aim of this study was to document how postoperative pain in children was managed routinely at Spanish surgical wards. The study was carried out in three hospitals on the first postoperative day. Children were divided in four groups according to their age (years): Group I (3–5), 11(6–8), III (9–11) and IV (12–14). The parameters evaluated were: analgesia characteristics (type of prescription, drug used and route of administration, prescribed dose and whether the drug was or was not administered, need of non-prescribed analgesics) and the postoperative pain intensity. The results were analysed using descriptive statistics. U-Mann Whitney, χ 2, ANOVA, Kruskall-Wallis and Student's t-test were also used. A total of 348 children ranging from 3 to 14 years were studied. The average age (± SD) was 8.2 ± 3.3 and the majority were male (74%). Urologic surgery was the most frequent type of operation, with age ( p <0.05) and hospital differences ( p<0.001). The majority of the patients (52%) were prescribed an analgesic, but only 26% of them had an analgesia order at fixed dosage intervals. Differences among the hospitals were observed ( p<0.001). The most commonly used analgesics were metamizol, propyphenazone, paracetamol and codeine. Differences in choice of drug in relation to age and hospital were significant ( p < 0.001). Rectal was the preferred route of drug administration. Patient's age was unrelated with the prescribed analgesic dose. An average of 68% of prescriptions were given and half of the patients without scheduled analgesia needed to have analgesics administered. Around 20% of patients had high pain scores. Few paediatric patients are given analgesics at fixed dose intervals to treat postoperative pain. Pain relief therapy for children differs notably to that of adults, in respect to the drugs prescribed and the administered route.