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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
POSTOPERATIVE PAIN AND STRESS RESPONSE: DOES CHILD'S GENDER HAVE AN INFLUENCE?
Marijana Karišik1, Najdana Gligorović Barhanović1, Tatjana Vulović1
11Department of Anesthesiology, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro; 2Centre for Clinical Laboratory Diagnostics, Clinical Centre of Montenegro, Podgorica, Montenegro; 3School of Medicine, University of Kragujevac, Kragujevac, Serbia; 4Centre for Anesthesiology and Resuscitation, Clinical Centre Kragujevac, Kragujevac, Serbia; 5School of Medicine, University of Belgrade, Belgrade, Serbia; 6University Children's Hospital, Belgrade, Serbia.
Insights
Male children experienced a greater neuroendocrine stress response and more intense postoperative pain after inguinal hernia repair. Parents reported higher satisfaction with care for girls.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Pediatric Endocrinology
Background:
- Surgical procedures induce a significant multisystem stress response.
- Understanding factors influencing this response, like gender, is crucial for optimizing pediatric surgical care.
- Previous research has not fully elucidated gender-specific differences in neuroendocrine responses and pain perception in pediatric surgical patients.
Purpose of the Study:
- To investigate the impact of gender on the neuroendocrine stress response to surgery.
- To assess gender-specific differences in postoperative pain intensity in children.
- To evaluate parental satisfaction with preoperative and postoperative care based on child's gender.
Main Methods:
- A comparative study involving 60 children (3-6 years old) undergoing inguinal hernia repair.
- Participants were divided into two groups: 30 boys and 30 girls, all American Society of Anesthesiologists PS Class I.
- Serum cortisol levels, pain intensity (Wong-Baker FACES scale), and parental satisfaction were measured preoperatively and postoperatively.
Main Results:
- Male children exhibited a significantly stronger neuroendocrine response to surgical stress compared to girls.
- Boys reported higher intensity of postoperative pain than girls.
- Parents of girls reported greater satisfaction with both preoperative and postoperative care.
Conclusions:
- Gender influences the neuroendocrine stress response and postoperative pain perception in pediatric patients undergoing inguinal hernia repair.
- Male children, particularly those who are the only child, may require tailored pain management strategies.
- Addressing parental concerns and enhancing communication could improve satisfaction, especially for male patients' families.
Abstract:
Surgical procedure causes multisystem stress response reactions. The aim of this study was to assess whether gender has an impact on the level of neuroendocrine response to surgical stress and intensity of postoperative pain in children undergoing inguinal hernia repair surgery, as well as satisfaction of their parents with preoperative and postoperative care. The study included 60 children aged 3-6 years, all of them the only child in the family. All children included in the study were categorized as American Society of Anesthesiologists PS Class I, and divided into two groups: group 1 composed of 30 boys and group 2 composed of 30 girls. After oral premedication with midazolam, general anesthesia with endotracheal intubation was performed in all patients. Ketorolac, 1 mg.kg-1, was administered for postoperative analgesia. Serum cortisol was measured in all children preoperatively and postoperatively. The quality of postoperative analgesia was evaluated by Wong-Baker (FACES) scale, along with parental satisfaction. Male children who were the only child in the family had stronger neuroendocrine response to surgical stress and stronger intensity of postoperative pain. The parents of the girls expressed greater satisfaction with preoperative and postoperative care.
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