Related Experiment Video
Updated: Aug 12, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
[Hormonal response and two special techniques of postoperative analgesia in pediatric surgery]
M A Palacio Rodríguez1, J Castejón Casado, E Palop Manjón-Cabeza
1Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de las Nieves, Departamento de Fisiología, Universidad de Granada.
Insights
Patient-controlled analgesia (PCA) and conventional intravenous analgesia effectively manage pediatric postoperative pain. PCA demonstrated a superior reduction in stress response markers like cortisol and catecholamines compared to conventional methods.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Neuroendocrinology
Background:
- Postoperative pain management in children is crucial for recovery.
- Neuroendocrine stress responses can impact surgical outcomes.
- Assessing analgesic techniques' impact on stress markers is vital.
Purpose of the Study:
- To compare neuroendocrine stress responses between patient-controlled analgesia (PCA) and conventional intravenous analgesia in pediatric surgical patients.
- To evaluate the efficacy of these analgesic techniques in managing postoperative pain.
- To analyze hormonal changes (catecholamines, cortisol, ACTH, beta-endorphin) and hemodynamic parameters.
Main Methods:
- A double-blind study involving 30 pediatric patients (6-14 years) undergoing programmed surgery.
- Postoperative analgesia administered via PCA or conventional intravenous methods.
- Measurements included hormone levels, hemodynamic monitoring, and pain scores at various postoperative intervals.
Main Results:
- Both techniques provided adequate pain relief with low pain scores.
- Beta-endorphin levels decreased in both groups.
- PCA group showed significantly less increase in cortisol and catecholamine levels postoperatively (p < 0.001).
Conclusions:
- Both PCA and conventional intravenous analgesia are suitable for pediatric postoperative pain relief.
- PCA may be a preferred method for mitigating the stress response in pediatric surgical patients.
- Effective pain management contributes to better patient recovery conditions.
Aims:
We studied neuroendocrine response in the postoperative pain relief in pediatric patients treated with two analgesic techniques (conventional intravenous analgesia and patient controlled analgesia).
Material And Methods:
A double blind study was made in 30 patients, 6-14 year-old children, under total intravenous anesthesia for programmed surgery. An intravenous analgesia dose of 0.5 mg/Kg was given 10 minutes before operation was finished. Postoperative analgesia was achieved by two techniques: A. Patient controlled analgesia (PCA), and B. Conventional intravenous analgesia every 6 hours. Hormones measurements were made (catecholamines, cortisol, ACTH and beta-endorphin), hemodynamic monitoring (blood pressure and heart rate), and pain measurement (Hannallah's score) in both pre and postoperative times (1, 6 and 24 hours after operation).
Results:
Pain score was low and without significant differences in both groups (p > 0.05). beta-endorphin level decreased in both groups, and a cortisol and catecholamine level increase was noticed at 6 hours after operation; these changes were less significant in PCA group (p < 0.001). ACTH level did not change significantly in both groups. Hemodynamic monitoring measurements were not significantly different.
Conclusions:
Both analgesic techniques were appropriate to postoperative pain relief in pediatric patients. Low pain score shows better conditions to attend these patients. We suggest PCA technique is better to treat postoperative stress response following pediatric surgery.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:25Analgesia and Pain Management
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:24Parenteral Anesthetics: Overview
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...