CHILDRENS SELF-REPORT OF POSTOPERATIVE PAIN INTENSITY AND TREATMENT THRESHOLD - DETERMINING THE ADEQUACY OF MEDICATION

Objective: Many studies have shown indirectly that children are underm edicated for postoperative pain. In this study, we used a pain self-re port scale to examine this more directly. Methods: We performed a surv ey with 63 children who were postoperative from minor, uncomplicated s urgery. Using the self-report scale, we determined the pain intensity at time of interview, the worst pain experienced postoperatively, and the intensity of pain that the subject felt to warrant pharmacologic i ntervention (the ''treatment threshold''). A subgroup of 48 children w as asked to indicate on the scale the intensities that represented mil d, moderate, and severe pain. Results: Mean (SD) pain at time of inter view was 1.9 (1.7) on the Oa scale. Mean worst postoperative pain was 3.8 (1.8). The mean for treatment threshold was 3.2 (1.8). We found ge nder differences in regard to the judgments about the intensities repr esenting mild, moderate, and severe pain, with girls rating these lowe r than did boys. Twenty-five percent of subjects reported pain that wa s mild, 29% reported moderate pain, and 46% reported severe pain. Conc lusions: We found that 51% of subjects were undermedicated for postope rative pain, being required to suffer pain that was above their treatm ent threshold. By determining each subject's treatment threshold and e stimate of moderate pain, we have better defined the intensity at whic h pain becomes clinically significant.