Korean J Anesthesiol.  2010 Mar;58(3):272-276. 10.4097/kjae.2010.58.3.272.

Pain management in pediatric day surgery patients at The Maternal and Child Medical Research Center in Mongolia

• Lee JU
• Enkhtuvshin S
• Ariuntungalag M
• Odgerel B
• Burmaa S
• Ganbold L

• KMID: 1854028
• DOI: http://doi.org/10.4097/kjae.2010.58.3.272

Abstract

BACKGROUND
Pediatric day surgery shortens the hospital stay, reduces the exposure of nosocomial infections and allows for active parental participation. But pain delays the recovery and it increases the morbidity, including nausea and vomiting, and the maladaptive behavioral changes. This study was conducted to compare the effect of rectally administered paracetamol or diclofenac combined with regional nerve block with the traditional pain control method. METHODS: Two hundred forty one randomly selected pediatric patients were allocated into two groups. The empirical pain relief group (the control group, n = 120) included the patients that received intravenous sulpyrin and/or meperidine postoperatively. The patients in the multimodal preemptive pain relief group (the study group, n = 121) received regional nerve blockade with 0.25% bupivacaine combined with preoperative rectally administered paracetamol 45 mg/kg or diclofenac 1 mg/kg 60 min before surgery for cases that were to undergo lower abdominal surgery. But only paracetamol or diclofenac was rectally administered preoperatively in the other surgical cases. RESULTS: The mean time in the recovery room for the study group was shorter than that for the control group. The postoperative pain was hurts even more in 16.7%, worst in 11.8%, a whole lot in 26.5% and no pain in 27.5% of the control group patients. But the pain was hurts little more only in 11%, a little bit in 10.0% and no pain in 88.9% of the study group patients. The average postoperative VAS score was 0.21 +/- 0.6 in the study group and 8.36 +/- 1.7 in the control group, respectively. Vomiting, nausea and fever were more frequently observed in the control group. CONCLUSIONS: The pain intensity of the children who were treated with rectally administered paracetamol or diclofenac combined with regional nerve block before surgery was significantly decreased as compared to that of the children who were treated with the traditional method.

Keyword

Neural blockade; Pediatric postoperative pain; Preemptive analgesia

MeSH Terms

Acetaminophen
Ambulatory Surgical Procedures
Bupivacaine
Child
Cross Infection
Diclofenac
Dipyrone
Fever
Humans
Isothiocyanates
Length of Stay
Meperidine
Mongolia
Nausea
Nerve Block
Pain Management
Pain, Postoperative
Parents
Recovery Room
Vomiting
Acetaminophen
Bupivacaine
Diclofenac
Dipyrone
Isothiocyanates
Meperidine