[Pediatric acute postoperative pain management service: 6 years' experience].

OBJECTIVE

[corrected] To describe the introduction and activities of a low-cost acute postoperative pain management service for children.

PATIENTS AND METHODS

A descriptive study of patients treated with patient-controlled analgesia (PCA), nurse-controlled analgesia (NCA), continuous epidural analgesia (CEA), and patient-controlled epidural analgesia (PCEA) from October 1998 through December 2004. We analyzed demographic information and data on most frequent surgical procedures, analgesic techniques, pain on our nurse observation scale, side effects (nausea and/or vomiting, pruritus, urinary retention, excessive sedation, respiratory depression), and parent and patient satisfaction.

RESULTS

Three hundred treatments per year were performed, for a total of 1870; 46.6% were in children under 5 years old. Orthopedic operations with osteotomy (22.5%) and laparotomies (13.4%) were the most common procedures. The most frequently used approach was NCA (53%), followed by PCA with bolus doses (24.5%), PCA with infusion (16.9%), and continuous epidural analgesia or PCEA (5.6%). On the nurse observation scale (no pain; slight, moderate or intense pain) absence of pain or slight pain was observed in 82%, 90%, and 94% of the patients on days 1, 2, and 3 after surgery. Postoperative nausea and vomiting were observed in 20% of the patients and respiratory depression in 0.16%. Satisfaction was good or very good for 98% of the parents and 94% of the children interviewed.

CONCLUSIONS

The pain management service in our hospital was able to control postoperative pain safely and effectively.