Gender differences in children's pain experience following tonsillectomy with or without adenoidectomy and/or myringotomy

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Abstract The purpose of this study was to determine if there are gender differences in children's behavioural responses to pain and self-reports of pain intensity, as well as responses to analgesic medications in the post anaesthesia care unit (PACU) and day surgery area. Eighty-seven children (3 to 12 years), undergoing tonsillectomy, were enrolled in the study. Pain intensity was measured using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and the Oucher. In the PACU, intravenous fentanyl (0.5 g kg −1 ) was administered on an ‘as needed' basis. CHEOPS scores were obtained prior to each fentanyl dose, five minutes after administration in the PACU, and hourly in the day surgery area. In the PACU, boys had higher pre-fentanyl and post-fentanyl CHEOPS scores than girls. Of the six categories of behaviour rated on the CHEOPS, boys had significantly higher pre-fentanyl scores for touch and legs, and higher post-fentanyl scores for touch, legs, and torso compared with girls. Children were unable to use the Oucher in the PACU. No gender differences were found in total fentanyl dose administered in the PACU. However, fentanyl doses were administered sooner to boys compared with girls. In the day surgery area, there were no significant gender differences in the CHEOPS scores. However, girls reported significantly higher pain intensity scores using the Oucher on discharge from the PACU and at the first hourly measure in day surgery. There were no significant gender differences in total fentanyl dose, time of administration, or length of stay in the day surgery area. Our data suggest that gender does influence children's behavioural responses to pain and self-report of pain intensity and may influence the timing of analgesic administration.