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Management of postoperative pain in children undergoing orthopaedic surgery
1State University Hospital in Copenhagen, Denmark.
Insights
Postoperative pain management for pediatric orthopedic surgery patients is often inadequate. Many children experience significant pain due to underdosing and as-needed administration of analgesics.
Area of Science:
- Pediatric Orthopedic Surgery
- Pain Management
- Pharmacology
Background:
- Effective postoperative pain management is crucial for pediatric orthopedic patients.
- Current practices in managing pain after lower extremity osteotomy in children require evaluation.
Purpose of the Study:
- To document routine postoperative pain management in pediatric orthopedic surgery.
- To assess the adequacy of current analgesic treatments for children undergoing elective osteotomy.
Main Methods:
- Study included children aged 6-14 years undergoing elective lower extremity osteotomy.
- Collected data on analgesic use (preoperative, perioperative, and first 3 days postoperative).
- Assessed children's pain experience using direct self-reporting.
Main Results:
- Twenty-three children participated; all received central- and peripheral-acting analgesics.
- As-needed administration was common, with doses frequently below recommended levels.
- 70% of children reported pain episodes, and 26% experienced severe pain.
Conclusions:
- Current postoperative pain management strategies for pediatric orthopedic surgery are insufficient.
- Improvements are needed in analgesic dosing and administration protocols.
- Enhanced pain management protocols are essential for better patient outcomes.
Abstract:
The aim of this study was to document how postoperative pain in children is managed routinely at a ward for orthopaedic surgery and to evaluate whether the treatment used is adequate. Children aged 6 to 14 years undergoing elective osteotomy at lower extremities were eligible. Information describing analgesic use preoperatively, perioperatively, and postoperatively for the first 3 days was collected. A direct self-reporting method was used to assess the children's experience of pain. Twenty-three children participated in the study. All children received analgesic treatment consisting of a central- and a peripheral-acting drug. As-needed administration was most common, and administered doses were often below the recommended doses. Of the children, 70% reported the experience of at least one episode of pain, and 26% experienced the worst pain they could imagine. It is still necessary to improve the care and efforts put into pain management.