|
November 1996
Parents' management
of children's pain following 'minor' surgery
Finley GA, et al;Pain.
[ see abstract below ]
Most procedures for children
are performed on an outpatient basis, and most anesthesiologists' knowledge
of the amount of post-operative pain that these children have is limited
to what they see during the brief in-hospital recovery period. The subsequent
pain management is left to the parents.
Allen Finley and his colleagues in Halifax have done an excellent survey
of the amount of pain children 2 - 12 years of age experienced during
the first 3 days after outpatient surgery, what their parents thought
about treatment of this pain, and what medications they actually administered.
The investigators found that post-operative pain clearly varied according
to the type of surgery (tonsillectomy, orchidopexy and circumcision were
the most painful on the day of surgery (Day 1)), and many children still
had clinically significant pain on Day 3. Most parents gave inadequate
doses of analgesics.
Pain after outpatient surgery in children is an area that deserves more
of our attention.
ABSTRACT
Summary
The aim of the investigation was to evaluate the prevalence, severity, and parents' management of children's pain following short-stay and day surgery. The subjects were 189 parents of children (2-12 years of age) who had undergone short-stay or day surgery.
Parents completed a 3-day diary of their child's pain and the methods used to alleviate it. There were clear differences in pain reported according to type of surgery. Some surgery, such as insertion of myringotomy tubes, appeared to cause little pain. Other procedures, including tonsillectomy, circumcision, and strabismus repair, resulted in about one-half the children experiencing clinically significant pain (> 30 mm on a 100 mm VAS).
Sixty-eight percent of the parents reported they had been instructed to use acetaminophen for pain 'if necessary', 13% had been told to use acetaminophen regularly, and 8% recalled no instructions. Of the parents who rated their child's pain as significant, 13% administered no pain medication and 47% gave 1-3 doses on day 2. On day 3, 17% gave no medication and 45% gave 1-3 doses. Some types of 'minor' surgery result in significant pain postoperatively.
Even when parents recognise that their children are in pain, most give inadequate doses of medication to control the pain.
Dr. G.A. Finley,
IWK Children's Hospital,
5850 University Ave.,
Halifax NS B3J 3G9, Canada.
Tel.: (902) 428-8251;
FAX: (902) 428-8826;
E-mail: gafinley@ac.dal.ca.
|
