Pain relief in children following outpatient surgery

Study Objective: To evaluate perioperative analgesia, prescription patterns , pain relief and parental care of children undergoing outpatient surgery. Design: Prospective data collection and parental interview. Setting: Large tertiary care university-based medical center. Patients: 471 children aged between 10 months and IS years who underwent an outpatient surgical procedure expected to be associated with pain. Measurements and Main Results: All perioperative data regarding analgesia, antiemetics, postoperative pain scores, and discharge prescriptions were re corded. Parents were telephoned 24 hours following surgery, and data concer ning their childs pain relief, analgesic and antiemetic usage, and their ab ility to care for their child were obtained. Of the 460 patients questioned , 97% were described by their parents as having adequate, good, or very goo d pain relief(acceptable) during the first 24 hours postoperatively, wherea s only 15 (3%) had poor pain relief (unacceptable). All patients received s ome form of analgesia intraoperatively. The children with poor pain relief were more likely to have experienced postoperative nausea and vomiting (p = 0.01) and were more difficult to care for at home (p < 0.0001). In a subse t of 185 patients who had genitourinary procedures, those who received regi onal analgesia reported better pain relief (p = 0.05). Conclusions: Despite a wide range of surgical procedures being performed on children on an ambulatory basis, current selection of patients for outpati ent surgery is appropriate given the ability of the parents to manage their children's pain and to care for their children at home. (C) 1999 by Elsevi er Science Inc.