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31-10-2011 | General practice | Article

Many children suffer unnecessary postoperative pain


Free abstract

MedWire News: A significant percentage of children undergoing operations suffer chronic postoperative pain unnecessarily, suggest study findings.

"Chronic postoperative pain is a well-established clinical phenomenon that is associated with adverse outcomes," explain Michelle Fortier (University of California-Irvine, Orange, USA) and colleagues in the Journal of Pediatric Surgery.

"The incidence of this clinical phenomenon in children, however, is not well established," they add.

Fortier and team recruited 113 children (69% male) and their parents to take part in a cross-sectional study investigating postoperative pain.

The children underwent surgery with general anesthesia between 2008 and 2009. Fifty-one percent of the children underwent orthopedic surgery, 39% general surgery, and 10% urologic surgery.

The researchers interviewed the children and their parents about the incidence, persistence, and characteristics of postoperative pain experienced by the children a mean 9 months after their surgery, when they were aged 12.4 years on average.

Fortier et al report that 15 (13.3%) of the children reported having chronic postoperative pain, which was supported by their parents. Of these, 10 children underwent orthopedic procedures.

Most of the children who experienced chronic pain said that it corresponded to their operation site. Pain was mostly intermittent (88% of children), but some children were in constant pain (12% of children).

The children described the pain using the following terms, namely, "sore, aching, hurting, squeezing, pulling, and pinching."

The median duration of the pain experienced was 4.1 months from initial surgery, with 85% of the children indicating that it started immediately after surgery.

A third of the children said that the pain they experienced interfered with their ability to participate in extracurricular activities and led to impaired sleep.

"Medical professionals must understand this issue better and learn how to work with parents to care for chronic pain," commented study author Zeev Kain, also from the University of California-Irvine, in a press statement.

"We hope this study marks a first step toward long-term, definitive solutions," he said.

The researchers concede that their study was small and cross-sectional, thus limiting the wider application of their results.

However, "given the large number of children who may be at risk for experiencing chronic postoperative pain, further understanding of this phenomenon, including preventative efforts, is necessary," they conclude.

By Helen Albert

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