Truncal blocks and teenager postoperative pain perception after laparoscopic surgical procedures

The prevalence of moderate to severe pain is high in hospitalized teenage patients admitted to surgical services.

The aims of this study were to determine (1) the preoperative and postoperative factors influencing teenager postoperative pain perception; and (2) suffering, defined as the patient's anxiety, pain catastrophizing thoughts, and mood.

Data were collected from medical records and from 2 medical interviews at the time of enrollment and postoperative day 1. Stepwise linear regression was conducted to assess variables that predicted teenagers' pain scores and suffering.

Two hundred two patients (mean age = 13.8 years, SD = 1.9), 56.4% females, scheduled for laparoscopic surgical procedures completed the study. The variables found to be significant predictors of pain response in teenagers were pain on the day of surgery (6.81, 95% confidence interval [CI] = 0.08-13.55, P = 0.05) and use of regional anesthesia (single-injection rectus sheath, transversus abdominis plane, and paravertebral nerve blocks) (-6.58, 95% CI = -12.87 to -0.30, P = 0.04). The use of regional anesthesia was found to predict mood responses (all patients: 2.60, 95% CI = 0.68-4.52, P = 0.01; girls: 3.45, 95% CI = 0.96-5.93, P = 0.01; 14-17-year-old teens: 2.77, 95% CI = 0.44-5.10, P = 0.02) and to negatively predict catastrophic thoughts among all patients as a group (-4.35, 95% CI = -7.51 to -1.19, P = 0.01) and among 14- to 17-year-old teens (-5.17, 95% CI = -9.44 to -0.90, P = 0.02).

A comprehensive pain approach that includes truncal blocks may improve teenagers' postoperative pain control after laparoscopic surgeries.