Abstract
Aim: To review peri-operative assessment of pain, documentation practices, management interventions, psychological preparation and followup in children.
Methods: A retrospective audit at the Homerton university hospital over a 12 month period from 1st Feb 2008 - 31st Jan 2009. All children operated on as elective day cases were included in the cohort. Patients who were transferred out postoperatively and those admitted post trauma were excluded.
Results: Total of 132 children were included in the audit. 107 (81%) had their pain assessed, of which 59 (44%) had it documented.39 children had nerve blocks, 27 of which were caudals, 7 had penile block, 2 were given rectus sheath block while 3 received ilio-inguinal block.33% of the patients who received nerve blocks required intra-operative opioids while 25% needed it postoperatively. 85% of blocks provided good pain relief. 25 patients, all under the age of five underwent lower abdominal surgeries. 22 were given caudal blocks while one received a penile block. One from the above group received both intra and post-op opioid.
Conclusions: • Majority of patients' pain is being managed appropriately. Caudal blocks appear to be adequate for analgesia for sub-umbilical surgeries. Training of junior doctors in procedural skills does not necessary impact on efficient delivery of care as shown in our cohort of successful caudal epidurals. Most of these were performed by a junior doctor under supervision from a senior consultant anaesthetist. Pain is not being assessed and documented as per recommendation by the Association of Paediatric Anaesthetists.
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Raman, S., Mir, F. & Mukhopadhyay, S. 1364 Peri-Operative Assessment and Management of Pain in Children. Pediatr Res 68 (Suppl 1), 675 (2010). https://doi.org/10.1203/00006450-201011001-01364
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DOI: https://doi.org/10.1203/00006450-201011001-01364