[What do adolescents desire for the postoperative pain relief?--a speculation from an interview with a patient]

Three different methods of postoperative pain management were evaluated by a 16 year old girl within 1 month after the last surgery who had undergone intrathoracic surgery three times during the six months. The postoperative pain management was different after each surgery. The first bullectomy was performed under thoracoscopy and she did not complain of severe pain with nerve blocks and NSAID suppository. After the second and third intrathoracic surgery, postoperative pain relief was tried with iv PCA and epidural morphine respectively. Although she commented that epidural morphine had been more potent than i.v. PCA from the viewpoint of pain relief, she preferred i.v. PCA to bolus administered epidural morphine because she could always control her pain whenever pain relapsed. Bolus epidural morphine, however, was administered by physicians only, and she endured severe pain for more than two hours until the next dose at the midnight of the operation. That might be the reason why she was not satisfied with epidural morphine. It was concluded that we should try to offer not fluctuating analgesic level but readily available potent analgesics which could be hopefully administered by patients themselves in adolescent or adult population.