Jensen B
Region Västra Götaland, Dept of Paediatric Dentistry, Gothenburg, Sweden.
Eur Arch Paediatr Dent. 2012 Jun;13(3):119-25. doi: 10.1007/BF03262857.
To evaluate post-operative pain in children and compare self-ratings of pain with those of a parent, and to study analgesic use after dental extractions under general anaesthesia (GA).
Prospective observational study.
One hundred children, aged 3-12 years, who had extractions performed under GA participated. After treatment, the child and one parent assessed post-operative pain on 5 occasions: before discharge, the evening of the treatment day, and the following three evenings. The parent rated the child's level of pain on a visual analogue scale (VAS), and the child made two ratings, one on a facial analogue scale (FAS) and one on a coloured analogue scale (CAS). Analgesics were recommended 3-4 times daily, and the parent recorded the intake.
Seventy-eight children only had primary teeth extracted, 8 children had both primary and permanent teeth extracted, and 14 children only had permanent teeth extracted. The median number of extracted primary teeth was 5 (range 1-12) and of permanent teeth 3 (range 1-4). The median pain ratings were highest in the post-operative ward, VAS=1.0 (max 9.2), FAS=2 (max 10), and CAS=1.4 (max 10). The second highest median values were in the evening following treatment. No significant differences were found between pain ratings of the parent and the child or between the two ratings of the child. 60% took analgesics on day 1. On day 2, 45% took analgesics, of which 29% more than once.
Spearman's rank correlation coefficient was used to test concordance between ratings.
Most children had mild or no pain, and parent and child pain ratings agreed well. The dentist's analgesic recommendations were often poorly followed.
评估儿童术后疼痛情况，比较儿童自我疼痛评分与家长评分，并研究全身麻醉（GA）下拔牙后的镇痛药物使用情况。
前瞻性观察研究。
100名3至12岁在GA下接受拔牙手术的儿童参与研究。治疗后，儿童及其一名家长在5个时间点评估术后疼痛：出院前、治疗当天晚上以及随后的三个晚上。家长使用视觉模拟量表（VAS）对儿童疼痛程度进行评分，儿童进行两次评分，一次使用面部模拟量表（FAS），另一次使用彩色模拟量表（CAS）。建议每日服用3 - 4次镇痛药，家长记录用药情况。
78名儿童仅拔除乳牙，8名儿童乳牙和恒牙均被拔除，14名儿童仅拔除恒牙。拔除乳牙的中位数为５颗（范围1 - 12颗），恒牙为3颗（范围1 - 4颗）。术后病房的疼痛评分中位数最高，VAS = 1.0（最大值9.2），FAS = 2（最大值10），CAS = 1.4（最大值10）。第二高的中位数出现在治疗后的晚上。家长与儿童的疼痛评分之间或儿童的两次评分之间均未发现显著差异。60%的儿童在第1天服用了镇痛药。在第2天，45%的儿童服用了镇痛药，其中29%的儿童服用不止一次。
采用Spearman等级相关系数检验评分之间的一致性。
大多数儿童疼痛轻微或无疼痛，家长和儿童的疼痛评分一致性良好。牙医的镇痛建议往往未得到很好的遵循。
