Skip to main content
SpringerLink
Log in
Book cover

Advances in Pain Therapy II pp 174–187Cite as

Postoperative Pain Treatment in Pediatric Patients

  • Conference paper

  • 76 Accesses

Abstract

Pediatric surgery has progressed to the point where children who would not have been operated on a few years ago are now cared for surgically. Pain is the inevitable consequence of most operations and caregivers are routinely confronted with acute pain in children. Pain leads to anxiety and uncontrolled agitation and children in pain will put out dressings, catheters and tubes. Pain results in arterial hypertension which can increase postoperative bleeding. On the other hand postoperative analgesia reduces psychological trauma due to the surgery [39] and facilitates respiratory therapy.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Agarwal R, Gutlove DP, Lockhart CM (1992) Seizures occurring in pediatric patients receiving continuous infusion of bupivacaine. Anesth Analg 75: 284–286

    Article  PubMed  CAS  Google Scholar 

  2. Anand KJS, Hickey PR (1987) Pain and its effects in the human neonate and fetus. N Engl J Med 317: 1321–1329

    Article  PubMed  CAS  Google Scholar 

  3. Anand KJS, Sippell WG, Aynsley-Green A (1987) Randomized trial of fentanyl anaesthesia in preterm babies undergoing surgery: Effects on the stress response. Lancet i: 243–247

    Article  Google Scholar 

  4. Anand KJS, Aynsley-Green A (1985) Metabolic effects of surgical ligation of patent ductus arteriosus in the human preterm neonate: are there implications for further improvements of postoperative outcome? Mod Probl Paediatr 23: 143–157

    Google Scholar 

  5. Attia J, Ecoffey C, Sandouk P, Gross J, Samii K (1986) Epidural morphine in children: pharmacokinetics and CO2 sensitivity. Anesthesiology 65: 590–594

    Article  PubMed  CAS  Google Scholar 

  6. Barrier G, Attia J, Mayer M-N, Amiel-Tisson C, Shnider SM (1989) Measurement of postoperative pain and narcotic administration in infants using a new clinical scoring system. Int Care Med 15: S37

    Google Scholar 

  7. Benlabed M, Ecoffey C, Levron JC, Flaisher B, Gross JB (1987) Analgesia and ventilatory response to CO2 following epidural sufentanil in children. Anesthesiology 67: 948–951

    Article  PubMed  CAS  Google Scholar 

  8. Berde CB, Sethner NF, De Jesus JM, Yemen TA, Mandell J (1990) Continuous epidural bupivacaine-fentanyl infusions in children undergoing urologic surgery. Anesth Analg 70: S22 (abstract)

    Article  Google Scholar 

  9. Berde CB, Lehn B, Yee JD, Sethna NF, Russo D (1991) Patient-controlled analgesia in children and adolescents: a randomized, prospective comparison with intramuscular morphine for postoperative analgesia. J Pediatr 118: 460–466

    Article  PubMed  CAS  Google Scholar 

  10. Bosenberg AT, Hadley GP, Munay WB (1991) Epidural analgesia reduces, post-operative ventilation requirements following esophageal atresia repair. J Pain Symptom Management 6: 209

    Article  Google Scholar 

  11. Bray RJ (1991) Postoperative analgesia provided by morphine infusion in children. Anaesthesia 38: 1075–1078

    Article  Google Scholar 

  12. Broadman LM, Vaughan M, Rice L, Randolph J (1989) Patient-controlled analgesia provides more effective postoperative pain control following Pectus excavatum repair in children than does conventional narcotic therapy. Anesthesiology 71: A1045

    Article  Google Scholar 

  13. Bricker SRW, Telford RJ, Booker PD (1989) Pharmacocinetics of bupivacaine following intraoperative intercostal nerve block in neonates and in infants aged less than 6 months. Anesthesiology 70: 942–947

    Article  PubMed  CAS  Google Scholar 

  14. Buzoni P, Sarti A (1987) Sacral intervertebral epidural block. Anesthesiology 67: 993–995

    Article  Google Scholar 

  15. Dalens BJ (1990) Infraclavicular brachial plexus blocks. In: Pediatric regional anesthesia. CRC, Boca Raton, pp 241–255

    Google Scholar 

  16. Dahlstrom B, Bolme P, Feychting H, Noack G, Paalzow L (1979) Morphine kinetics in children. Clin Pharmacoi Ther 26: 354–365

    CAS  Google Scholar 

  17. Desparmet J, Meistelman C, Barre J, Saint-Maurice C (1987) Continuous epidural infusion of bupivacaine for postoperative pain relief in children. Anesthesiology 67: 108–110

    Article  PubMed  CAS  Google Scholar 

  18. Ecoffey C, Dubousset AM, Samii K (1986) Lumbar and thoracic epidural anesthesia for urologic and upper abdominal surgery in infants and children. Anesthesiology 65: 87–90

    Article  PubMed  CAS  Google Scholar 

  19. Eland JM, Anderson JE (1977) The experience of pain in children. In: Jacox AK (ed) Pain: a source book for nurses and other health professionals. Little Brown, Boston, pp 453–473

    Google Scholar 

  20. Fletcher AB (1987) Pain in the neonate. N Engl J Med 317: 1347–1348

    Article  PubMed  CAS  Google Scholar 

  21. Gaffney A (1988) How children describe pain: a study of words and analogies used by 5–14 years old. Proceedings of the Vth Congress on Pain, Elsevier, Amsterdam

    Google Scholar 

  22. Gaukroger PB, Tomkins DP, Van Der Walt JH (1989) Patient-controlled analgesia in children. Anaesth Intensive Care 17: 264–268

    PubMed  CAS  Google Scholar 

  23. Gauntlett IS (1987) Analgesia and anesthesia in newborn babies and infants. Lancet i: 1090

    Google Scholar 

  24. Gibaldi M, Perrier D (1982) Pharmacokinetics, 2nd edn. Marcel Dekker, New York, pp 28

    Google Scholar 

  25. Glenski JA, Warner MA, Dawson B, Kaufman B (1984) Postoperative use of epidurally administered morphine in children and adolescents. Mayo. Clin Proc 59: 530–533

    PubMed  CAS  Google Scholar 

  26. Granry JC, Rod B, Boccard E, Hermann P, Gendron A, Saint Maurice C (1992) Pharmacokinetics and antipyretic effects of an injectable pro-drug of paracetamol (propacetamol) in children. Paediatr Anaesth 2: 291–295

    Article  Google Scholar 

  27. Hannallah RS, Broadman LM, Belman AB, Abramovitz MD, Eptein BS (1987) Comparison of caudal and ilioinguinal/iliohypogastric nerve blocks for control of post orchidopexy pain in pediatric ambulatory surgery. Anesthesiology 66: 832–834

    Article  PubMed  CAS  Google Scholar 

  28. Hertzka RE, Gauntlett IS, Fischer DM, Spelhman MJ (1989) Fentanyl induced ventilatory depression: effects of age. Anesthesiology 70: 213–218

    Article  PubMed  CAS  Google Scholar 

  29. Jaffe JH, Martin WR (1985) Opioid analgesics and antagonists. In: Gilman AG, Goodman LS, Rall TW, Murad F (eds) The pharmacological basis of therapeutics, 7th edn. Macmillan, New York, pp 491–531

    Google Scholar 

  30. Jeans ME (1983) Pain in children: a neglected area. In: Firestone P, McGrath P, Feldman W (eds) Advances in behavioral medicine for children and adolescents. Erlbaum, Hillsdale, NJ, pp 23–38

    Google Scholar 

  31. Jensen BH (1981) Caudal block for post-operative pain relief in children after genital operations. A comparison between bupivacaine and morphine. Acta Anaesthesiol Scand 25: 373–375

    Article  PubMed  CAS  Google Scholar 

  32. Jones MA (1989) Identifying signs that nurses interpret as indicating pain in newborns. Pediatr Nurs 15: 75–79

    Google Scholar 

  33. Kay AE, Wandless J, James RH (1982) Analgesia for circumcision in children — a comparison of caudal bupivacaine and intramuscular buprenorphine. Acta Anaesthesiol Scand 26: 331–333

    Article  Google Scholar 

  34. Kay B (1974) Caudal block for post operative pain relief in children. Anaesthesia 29: 610–614

    Article  PubMed  CAS  Google Scholar 

  35. Koren G, Butt W, Chinyanga H, Soldin S, Tan Y, Pape K (1985) Postoperative morphine infusion in newborn infants: assessment of disposition characteristics and safety. J Pediatr 107: 963–967

    Article  PubMed  CAS  Google Scholar 

  36. Krane EJ, Jacobson LE, Lynn AM, Parrot C, Tyler D (1987) Caudal morphine for postoperative analgesia in children: a comparision with caudal bupivacaine and intravenous morphine. Anesthesiology 66: 647–653

    Article  CAS  Google Scholar 

  37. Krane EJ (1988) Delayed respiratory depression in a child after caudal epidural morphine. Anesth Analg 67: 79–82

    Article  PubMed  CAS  Google Scholar 

  38. Krane EJ, Tyler DC, Jacobson LE (1989) The dose response of caudal morphine in children. Anesthesiology 71: 48–52

    Article  PubMed  CAS  Google Scholar 

  39. Levy DM (1945) Psychic trauma of operations in children. Am J Dis Child 69: 7–25

    Google Scholar 

  40. Lynn AM, Opheim KE, Tyler DC (1982) Morphine infusion after pediatric cardiac surgery. Crit Care Med 12: 863–866

    Article  Google Scholar 

  41. Martin LVH (1982) Postoperative analgesia after circumcision in children. Br J Anaesth 54: 1263–1266

    Article  PubMed  CAS  Google Scholar 

  42. Maunuksela EL, Olkkola KT, Koyela R (1988) Does prophylactic intravenous infusion of indomethacin improve the management of postoperative pain in children? Can J Anaesth 35: 123–127

    Article  PubMed  CAS  Google Scholar 

  43. Maunuksela EL, Koyela R, Olkkode KT (1988) Double-blind, multiple-dose comparison of buprenorphine and morphine in postoperative pain of children. Br J Anaesth 60: 48–55

    Article  PubMed  CAS  Google Scholar 

  44. Maunuksela EL, Koyela R, Olkkola KT (1988) Comparison of buprenorphine with morphine in the treatment of postoperative pain in children. Anesth Analg 67: 233–239

    Article  PubMed  CAS  Google Scholar 

  45. Maunuksela EL, Kakki H, Bullingherm RES (1992) Comparaison of intravenous ketarolac with morphine for postoperative pain in children. Clin Pharmacol. Ther 52: 436–443

    Article  PubMed  CAS  Google Scholar 

  46. Mc Closkey JJ, Haun JE, Deshpande JK (1992) Bupivacaine toxicity secondary to continuous caudal epidural infusion in children. Anesthesiology 75: 287–290

    Google Scholar 

  47. Mc Grath PA, De Veber LL, Hearn MT (1985) Multidimensional pain assessement in children. In: Fielfs HL, Dubner R, Cervero F (eds) Advances in pain research and therapy. Raven, New York, pp 387–393

    Google Scholar 

  48. McGrath PJ, Johnson G, Goodman JT, Schillinger J, Dunn J, Chapman J (1985) The CHEOPS: a behavioral scale to measure postoperative pain in children. In: Fielfs HL, Dubner R, Cervero F (eds) Advances in pain research and therapy. Raven, New York, pp 395–402

    Google Scholar 

  49. McIlvaine WB, Knox RF, Fennessey PV, Goldstein M (1988) Continuous infusion of bupivacaine via intrapleural catheter for analgesia after thoracotomy in children. Anesthesiology 69: 261–264

    Article  PubMed  CAS  Google Scholar 

  50. McNeely JM (1991) Comparison of epidural and intravenous opioids in the post-operative management of pediatric anti-relux surgery. Anesthesiology 75: A689

    Article  Google Scholar 

  51. Meigner M, Souron R, Le Nell JC (1983) Postoperative dorsal epidural analgesia in the child with respiratory disabilities. Anesthesiology 59: 473–475

    Article  Google Scholar 

  52. Merskey H (1970) On the development of pain. Headache 10: 116–123

    Article  PubMed  CAS  Google Scholar 

  53. Miller RR, Jick H (1978) Clinical effects of meperidine in hospitalized patients. J Clin Pharmacol 18: 180–189

    PubMed  CAS  Google Scholar 

  54. Nahata MC, Powell DA, Dunel DE, Miller MA (1984) Acetaminophen accumulation in pediatric patients after repeated therapeutic doses. Eur J Clin Pharmaco 127: 57–59

    Google Scholar 

  55. Newburger PE, Sallan SE (1981) Chronic pain: principles of management. J Ped 98: 180–189

    Article  CAS  Google Scholar 

  56. Olkkola KT, Maunuksela EL (1991) The pharmacokinetics of postoperative intravenous ketoralac tranethamine in children. Br J Clin Pharmacol 31: 182–184

    PubMed  CAS  Google Scholar 

  57. Parker RK, Holtmann B, White PF (1991) Patient-controlled analgesia does a concurrent opioid infusion improve pain management after surgery? JAMA 266: 1947–1952

    Article  PubMed  CAS  Google Scholar 

  58. Porter J, Jick H (1980) Addiction rate in patients treated with narcotics. N Engl J Med 302: 123–127

    PubMed  CAS  Google Scholar 

  59. Rita L, Gooderzi M, Seleny F (1981) Effect of low dose droperidol on postoperative vomiting in children. Can Anaesth Soc J 28: 259–262

    Article  PubMed  CAS  Google Scholar 

  60. Rodgers BM, Webb CJ, Stergios D, Newman BM (1988) Patient-controlled analgesia in pediatric surgery. J Ped Surg 23: 259–262

    Article  CAS  Google Scholar 

  61. Ronchi L, Rosenbaum D, Athouel A, Lemaitre JL, Bermon F, de Villepoix C, Le Normand Y (1989) Femoral nerve blockade in children using bupivacaine. Anesthesiology 70: 622–624

    Article  PubMed  CAS  Google Scholar 

  62. Rosen KR, Rosen DA (1989) Caudal epidural morphine for control of pain following open heart surgery in children. Anesthesiology 70: 418–421

    Article  PubMed  CAS  Google Scholar 

  63. Rothstein P, Arthur GR, Feldman HS, Kop GS, Covino GB (1986) Bupivacaine for intercostal nerve blocks in children: blood concentration and pharmacokinetics. Anesth Analg 65: 625–632

    Article  PubMed  CAS  Google Scholar 

  64. Saint-Maurice C (1990) Analgesie postoperatoire. In: Manuel d’Anesthesie Pediatrique, Pradel, Paris, pp 395–405

    Google Scholar 

  65. Schechter NL, Allen DA, Hanson K (1986) The status of pediatric pain control: a comparision of hospital analgesic usage in children and adults. Pediatrics 77: 11–15

    PubMed  CAS  Google Scholar 

  66. Shandling B, Stewart DJ (1980) Regional analgesia for post-operative pain in pediatric outpatient surgery. J Pediatr Surg 15: 477–480

    Article  PubMed  CAS  Google Scholar 

  67. Shapiro LA, Jedeikin RJ, Shalev D, Hoffman S (1984) Epidural morphine analgesia in children. Anesthesiology 61: 210–212

    Article  PubMed  CAS  Google Scholar 

  68. Tigerstedt I, Leawder P, Tammistot (1981) Postoperative analgesics for superficial surgery. Comparison of four analgesics. Acta Anaesth Scand 25: 543–547

    Article  PubMed  CAS  Google Scholar 

  69. Tree-Trakarn T, Pirayavaraporn S (1985) Postoperative pain relief for circumcision in children: comparison among morphine, nerve block and topical analgesia. Anesthesiology 62: 519–522

    Article  PubMed  CAS  Google Scholar 

  70. Tverskoy M, Cozacov C, Ayache M, Bradley EL Jr, Kissin I (1990) Postoperative pain after inguinal hernia repair with different types of anesthesia. Anest Analg 70: 29–35

    Article  CAS  Google Scholar 

  71. Vater M, Wandless J (1985) Caudal or dorsal nerve block? A comparison of two local anaesthetic techniques for postoperative analgesia following day case circumcision. Acta Anaesthesiol Scand 29: 175–179

    Article  PubMed  CAS  Google Scholar 

  72. Warner MA, Kunkel SE, Offord KO, Atchison SR, Dawson B (1987) The effects of age, epinephrine, and operative site on duration of caudal analgesia in pediatric patients. Anesth Analg 66: 995–998

    Article  PubMed  CAS  Google Scholar 

  73. Wolf AR, Valley RD, Fear DW, Roy DW, Lerman J (1988) Bupivacaine for caudal analgesia in infants and children: the optimal effective concentration. Anesthesiology 69: 102–106

    Article  PubMed  CAS  Google Scholar 

  74. Zhang AZ, Pasternak GW (1981) Ontogeny of opioid pharmacology and receptors: high and low affinity site differences. Eur J Pharmacol 73: 2940

    Article  Google Scholar 

Download references

Authors
  1. C. Ecoffey
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

    J. Chrubasik M. D. (Professor of Anesthesiology) & E. Martin M. D., F.F.A.R.A.C.S. (Professor of Anesthesiology) (Professor of Anesthesiology) &  (Professor of Anesthesiology)

  2. Department of Anesthesiology, University of Sydney, Royal North Shore Hospital, St. Leonards, NCW 2065, Australia

    M. J. Cousins M. D., F.F.A.R.A.C.S. (Professor of Anaesthesiology) (Professor of Anaesthesiology)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Ecoffey, C. (1993). Postoperative Pain Treatment in Pediatric Patients. In: Chrubasik, J., Martin, E., Cousins, M.J. (eds) Advances in Pain Therapy II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78341-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78341-8_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56917-6

  • Online ISBN: 978-3-642-78341-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation