[Pain and anxiety in pediatric surgery]

Postsurgery pain is a common complaint in children and significant postoperative pain may last for weeks. Severe perisurgery pain may aggravate long-lasting negative effects. In order to prevent harmful effects, children should be provided with effective-secure analgesia. The aim of this work was to determine current practice of postsurgery pain management in children.

An observational prospective study in pediatric patients undergoing surgery in our hospital was performed. Children's (< 14 years old) having elective major surgery and outpatient surgery were collected prospectively. Clinical stage, surgery and anaesthesia procedures, postsurgery analgesia and perioperative complications were recorded. Pain control was measured by an analogic visual scale (AVS) before surgery, in post-anaesthesia recovery unit (PARU), in one-day unit (ODU) and 24 h after surgery (24hU).

mean values +/- sem or SD, frequency and percentage of incidence of N cases, t-test, ANOVA of one and several ways, chi-square, correlations of two variables, linear and logistic regressions depending of variables' types.

77 patients with mean age of 5 years old and mean weight of 22 kg were studied. The most frequently employed anesthetic technique was the general one. Forty per cent of the patients were pre-medicated with midazolam. Little pain before surgery is observed and after surgery it is moderate. Anxiety is higher after surgery and immediately after it in the recovery room or the Post Anesthesia Care Unit (PACU), subsequently it diminishes, especially patients with same-day admission surgery. Positive correlations between pain and anxiety intensities were found in each determination done.

Is observed that pain and anxiety round surgery in children had insufficient treatment, reason why we think we should make treatment protocols, adapted at this population, its necessities and the different types of procedures they can be subjected.