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Postoperative pain after adenoidectomy in children
E Nikanne1, H Kokki, K Tuovinen
1Department of Otorhinolaryngology, Kuopio University Hospital, Finland.
Insights
Pain intensity and fentanyl use in hospital after adenoidectomy predicted home pain levels in children. Pre-emptive ketoprofen did not reduce post-operative pain at home.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Outcomes
Background:
- Post-adenoidectomy pain is common in children.
- Predicting home pain levels is crucial for effective management.
- Pre-emptive analgesia aims to reduce post-operative pain.
Purpose of the Study:
- To determine if in-hospital pain and analgesic needs predict post-adenoidectomy pain at home.
- To assess the effect of pre-emptive intravenous ketoprofen on home pain.
- To investigate analgesic requirements in young children undergoing day-case adenoidectomy.
Main Methods:
- Prospective, randomized, double-blind, placebo-controlled study in 611 children (1-7 years).
- Standard anesthesia with fentanyl rescue; post-discharge open-label ketoprofen.
- Pain and analgesic data collected via diaries and telephone follow-up.
Main Results:
- In-hospital fentanyl doses significantly correlated with home pain intensity (P < 0.001).
- No other significant correlations found between in-hospital and home pain parameters.
- Pre-emptive intravenous ketoprofen showed no significant effect on home pain management.
Conclusions:
- In-hospital analgesic requirements, specifically fentanyl use, can predict post-adenoidectomy pain intensity at home.
- Pre-emptive intravenous ketoprofen is not effective in reducing pain after day-case adenoidectomy.
- Further research needed on optimizing pediatric post-operative pain control strategies.
Abstract:
We have investigated if pain intensity or analgesic requirements in hospital predicted pain intensity, pain duration or analgesic requirements at home in 611 children, aged 1-7 yr, after day-case adenoidectomy. We also investigated if ketoprofen 0.3-3.0 mg kg-1, administered pre-emptively i.v. during operation, modified pain at home. In hospital, a prospective, randomized, double-blind, placebo-controlled study design was performed. A standard anaesthetic technique was used in all children and fentanyl i.v. was available for rescue analgesia. After discharge, the study design was open, experimental, prospective and longitudinal. On return home, children were prescribed ketoprofen tablets 5 mg kg-1 day-1. Parents were asked to complete an analgesia diary; non-responders were contacted by telephone. The response rate was 91%. The number of doses of fentanyl given in hospital correlated with pain intensity at home (P < 0.001). There were no other correlations and no pre-emptive effect of ketoprofen.