[Parental perception of their child's pain tolerance and abdominal postoperative analgesic requirements]

to determine if a child's pain tolerance as perceived by their parents could predict the difficulty of a child's post-abdominal surgery pain control.

a prospective cohort study; children (3 to 16 years old) perceived as tolerant (PT) and non-tolerant to pain (NoPT). The analgesic plan was decided by their surgeons. We analyzed the level of pain (through Wong-Baker facial pain scale) and analgesic requirements (drug, dose modifications) immediately after recovery from anesthesia, 24 and 48 hours later.

62 patients were evaluated (34 PT and 28 NoPT). Since the recovery NoPT children requested more analgesics (42.9 % versus 2.9 %, p < 0.001) and higher doses. At 24 hours, although 87 % received analgesia, NoTP children required extra doses (50 % versus 23.5 % PT, p = 0.03). After 48 hours, 83 % (PT) and 72 % (NoPT) kept receiving analgesia (p = 0.36) but the NoPT still asked for more rescue doses (46.7 % versus 14.7 %, p = 0.01).

it is important to identify children perceived as poorly tolerant or not tolerant to pain before a painful procedure, in order to plan an efficient strategy for pain control.