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Post-operative pain management

  • Symposium: Pediatric Surgery — Part II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

“… He was particularly glad that she always put her victim to sleep before eating it … ‘Yes’, she replied in her sweet musical voice, ‘I always give them an anaesthetic so they won't feel pain. It's a little service I throw in!’”Charlotte A. Cavatica from,Charlotte's Web, by E.B. White, 1952

Abstract

For many years pediatric procedural and postoperative pain has been undertreated or not treated. In some areas this practice still exists and is a likely reflection of persistence of myths related to the infant's ability to perceive pain. Such myths include the lack of ability to perceive pain or remember painful experiences. New literature exists showing that these former beliefs do not hold true. The appropriate management of postoperative pain is contingent on a cooperative effort from pediatric surgeons, pediatric anesthesiologists, pediatricians, and parents. There are many ways to treat postoperative pain. The method of postoperative analgesia depends on the patient, underlying medical conditions, the type of surgery, the patient's disposition following surgery (inpatient vs. outpatient), and the physician's comford level with a particular analgesic regimen. Many pediatric anesthesiologists and surgeons have excellent success with the utilization of regional anesthetic techniques as treatment for postoperative pain. Caudal epidural blocks, ilioinguinal/iliohypogastric nerve blocks, and penile nerve blocks are some of the commonly used blocks. These blocks not only provide excellent postoperative analgesia, but are great adjuncts to general anesthesia, thus, reducing the amount of general anesthesia required. Additionally, the use of epidural opioids is extremely useful in patients following major abdominal, thoracic, and orthopedic surgery. Traditional medications such as oral and parenteral narcotics, non-steroidal anti-inflammatory drugs, and acetaminophen (paracetamol), are much more commonly used to treat postoperative pain. Regardless of the analgesic regimen chosen, we must assure our pediatric patients the least painful perioperative experience possible.

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Authors and Affiliations

  1. Department of Anesthesiology, Division of Pediatric Anesthesiology, The University of Illinois College of Medicine, 1740 West Taylor Street, Suite 3200 Mail Code 515, 60612, Chicago, Illinois, USA

    Richard A. Berkowitz & Timothy B. McDonald

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  1. Richard A. Berkowitz
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Berkowitz, R.A., McDonald, T.B. Post-operative pain management. Indian J Pediatr 64, 351–367 (1997). https://doi.org/10.1007/BF02845204

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