An audit of pain and vomiting in paediatric day case surgery

Tan, So-Wan; May, H.A.; Cunliffe, Mary

doi:10.1111/j.1460-9592.1994.tb00137.x

Cited by 13 publications

(19 citation statements)

References 6 publications

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“…The results indicated that 85 percent of the children slept as usual but 15 percent woke in pain. These findings are similar to other studies in that Tan et al (1994) found 15 percent of children experienced a disturbed night due to pain, whereas Ling (1996) established that 2 percent of children had a restless night due to discomfort. The high percentage of children having a complete night's sleep may have been due to the information in the leaflet, which suggested to parents that they give their child a dose of pain relief at bedtime.…”

Section: Discussionsupporting

confidence: 91%

“…Many studies have previously reported circumcision as being associated with severe pain (Tan et al, 1994). In this study there were eight children who underwent circumcision with a mean age of 6.5 years; all the children undergoing circumcision received a local anaesthetic block, Paracetamol and Ibuprofen.…”

Section: Pain and Type Of Surgerymentioning

confidence: 99%

“…Some previous studies have indicated that certain operations are more painful than others (Finley et al, 1996;Ho and Keneally, 2000;Knight, 1994;Kotiniemi et al, 1997;Tan et al, 1994). The pain scores of the three groups of children who had undergone circumcision, orchidopexy and dental surgery were compared (Figure 4).…”

Section: Pain and Type Of Surgerymentioning

confidence: 99%

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Parent's Management of their Child's Pain in the Home Following Day Surgery

Jonas

2003

J Child Health Care

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When a child returns home following day case surgery, the parent becomes responsible for the assessment and treatment of their child's pain. Pain is documented as being the most common complication following day case surgery. The study investigated parental management of their child's pain at home following day surgery. A purposive sample of 100 parents of children undergoing day case surgery at a regional paediatric hospital was obtained. Parents were contacted by telephone in their own home 24 hours after day surgery and, through a structured interview schedule, were asked a series of questions relating to their child's pain management and discharge information. The results indicated that parents managed their child's pain in the home if provided with information and suitable analgesia on discharge. Instigation of telephone follow-up for parents was upheld as a measure to provide support to parents, as 79 percent of parents found the telephone call useful.

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Section: Discussionsupporting

confidence: 91%

Section: Pain and Type Of Surgerymentioning

confidence: 99%

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Parent's Management of their Child's Pain in the Home Following Day Surgery

Jonas

2003

J Child Health Care

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“…PONV has been the most important reason for unanticipated admissions [2,23], but this was not the case in our survey. The overall incidence of PONV was also relatively low, even in the case of tonsillectomy (31% compared with up to 70-80% in some studies).…”

Section: Nausea and Vomitingmentioning

confidence: 54%

“…Pain, postoperative nausea and vomiting (PONV) and the risk of bleeding should be avoided [1]. In the few studies in which follow-up covers the time after discharge, pain has been problematical in children after circumcision [2,3] and PONV has been most common after strabismus surgery and tonsillectomy [4,5]. The choice of anaesthetic technique can modify morbidity at home.…”

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confidence: 99%

Postoperative symptoms at home following day‐case surgery in children: a multicentre survey of 551 children

et al. 1997

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SummaryThe incidence and duration of postoperative symptoms in children at home following day-case anaesthesia and surgery was evaluated using a questionnaire completed by parents of 551 children aged 4 months to 13.4 years (mean 3.8 years). They also evaluated the instructions given in hospital for care at home. The incidence of all symptoms was highest at home on the day of the operation. No postoperative symptoms were reported in 79 (14%) children. The incidence of pain was 56% and the only significant predictor was the type of operation, tonsillectomy being the most problematic (mild pain in 38% and severe in 25%; pain lasted 7 days or longer in 33%). Analgesics were given to 78% of all the children reported to have pain on the day of the operation, to 60% the next day and later to 58%; 19 (3%) children were given more than two doses per day. The instructions given in hospital for the treatment of pain were considered inadequate by 12% of parents. Postoperative nausea and vomiting occurred in 13% of children. Predictors by multiple stepwise logistic regression analysis were emetic symptoms in hospital, pain at home, age > 5 years and administration of postoperative opioid (pethidine or fentanyl). Opioid given during anaesthesia (fentanyl or alfentanil) did not increase the incidence. Emetic symptoms were most common after tonsillectomy (31%). The highest incidences of emetic symptoms (37%), sedation (96%) and dizziness (41%) occurred in children who had been given fentanyl for postoperative pain. Undertreatment of nausea in hospital was evident as only two children had received anti-emetics, even though 61 were reported to have emetic symptoms. Administration of effective anti-emetics should be encouraged, as emetic symptoms in hospital were the most significant predictor of nausea and vomiting at home. Treatment of pain at home and instructions for treatment of pain need to be improved.

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Nitrous oxide does not increase vomiting in children after myringotomy

et al. 1995

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The aim of this study was to establish whether nitrous oxide has a clinically important effect on postoperative vomiting in children after myringotomy. We studied 320 healthy children of ages 0. Vomiting after general anaesthesia in children is common and may result in considerable postoperative morbidity.This vomiting is of multifactorial aetiology of which nitrons oxide is a possible contributing factor. Nitrous oxide may induce vomiting by causing bowel distension, decreasing gastric motility, increasing middle ear pressure or interacting with endogenous opioid receptors. ~-3Among adults undergoing minor gynaecological surgery, as little as a 10-14 min exposure to N202 has been associated with increased vomiting. 3 Overall, the resuits of adult investigations have been controversial. Both an emetic 2-5 and lack of effect 6-9 have been reported. There have been two paedia~c studies. Pandit et al. failed to demonstrate a difference in vomiting after tonsiUectomy (62% vs 76%). 6 In another study of 104 children, nitrous oxide increased vomiting after myringotomy from 4% to CAN J ANAESTH 1995 / 42:4 / pp 274-6

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An audit of pain and vomiting in paediatric day case surgery

Cited by 13 publications

References 6 publications

Parent's Management of their Child's Pain in the Home Following Day Surgery

Parent's Management of their Child's Pain in the Home Following Day Surgery

Postoperative symptoms at home following day‐case surgery in children: a multicentre survey of 551 children

Nitrous oxide does not increase vomiting in children after myringotomy

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