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Patterns of post-operative analgesic usage in adults and children
1Department of Paediatrics, Kota Bharu Hospital, Kota Bharu, Kelantan.
Insights
Children received fewer postoperative analgesics after major intra-abdominal surgery compared to adults. This study highlights the under-usage of pain relief in pediatric patients and suggests improved analgesic administration is needed.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Postoperative pain management is crucial for patient recovery.
- Under-usage of analgesics is a recognized issue in both pediatric and adult populations.
- Intra-abdominal surgery presents significant postoperative pain challenges.
Purpose of the Study:
- To characterize analgesic prescribing and administration patterns in adult and pediatric patients undergoing major intra-abdominal surgery.
- To identify disparities in postoperative pain management between children and adults.
Main Methods:
- Retrospective chart review of patients undergoing intra-abdominal surgery at USM Hospital (Jan-Mar 1995).
- Data collected included patient demographics, type of analgesics, and ordered vs. administered analgesic data.
- Patients were categorized as children (≤12 years) and adults (>12 years).
Main Results:
- Narcotic analgesics were predominantly ordered for both groups (adults 95.5%, children 97%).
- Postoperative analgesics were ordered significantly more for adults (100%) than children (69%).
- Analgesic administration rates were lower in children (39.4%) compared to adults (70%), with intramuscular administration being most common.
Conclusions:
- Children undergoing major intra-abdominal surgery at this institution received significantly less ordered and administered analgesia compared to adults.
- Findings indicate a need for increased attention to postoperative pain relief in pediatric surgical patients.
- Optimizing analgesic strategies for children post-intra-abdominal surgery is essential.
Abstract:
There appears to be a general tendency towards under-usage of analgesics not only in children but also in adults. The aim of this study was to describe the pattern of analgesic usage in adults and children admitted for major intra-abdominal surgery. All patients who had intra-abdominal surgery at University Science Malaysia Hospital (USM Hospital) from 1st January to 31st March 1995 were included in the study. Children were patients of 12 years and below and adults were patients above 12 years of age. Data including age, sex, weight, type of analgesics used, the number of patients who had analgesics ordered and administered post-operatively were obtained from the patients' medical record. A total of 48 children and 67 adults were studied. Narcotic analgesics were the most common analgesics ordered both in adults (95.5%) and in children (97%). Post-operative analgesics were ordered significantly more often for adults 67 (100%) than for children 33 (69%) (p < 0.0001). In adults, 70% of patients who had analgesics ordered post-operatively had their analgesics administered, but in children only 39.4% of patients had their analgesics administered (p < 0.001). The most common route of administration was intramuscular in both adults (95.5%) and children (88%). Analgesics were more likely to be administered in the intensive care units (100%) than in the surgical wards (60%) (p = 0.049). Elective or emergency surgery and the time of day when surgery was performed did not affect the frequency of analgesics ordered or administered. In summary, children in this hospital had less analgesics ordered and administered following intra-abdominal surgery compared to adults. The results of this study imply that increased attention should be given to relieve postoperative pain with analgesic drugs in children.