Postoperative pain

Abstract

Concentrations associated with arousal in children are analogous to adults. The ability to recall and remember occurs at similar concentrations to those associated with arousal. A concentration of 1 mg.l(-1) was associated with a sedation level of three or less (arouses to consciousness with moderate tactile or loud verbal stimulus) in 95% of children while 1.5 mg.l(-1) was associated with a sedation level of two or less (rouses slowly to consciousness with sustained painful stimulus) in 95% of children. These concentrations can be attained for 3-4 min after 1 mg.kg(-1) and 1.5 mg.kg(-1) ketamine IV bolus, respectively. The mean arousal time can be anticipated at approximately 10 min (1 mg.kg(-1)) and 15 min (1.5 mg.kg(-1)).

Postoperative Pain in Children After Dentistry Under General Anesthesia

“…Children's self-report of their pain is the gold standard and preferred over observational reports, given that pain is a subjective experience. 3,17 Faces Pain Scale-Revised. The selection of the Faces Pain Scale-Revised (FPS-R) for this study was based upon its appropriateness and preference in children, 3 advantages, reputability, and interpretability.…”

“…Our literature review identified 6 publications that studied morbidity following pediatric dental rehabilitation under GA 1,9,13,[15][16][17][18][19][20][21][22][23] and 4 studies that focused on postoperative pain as their primary outcome. 15,19,22,23 While collective interpretation of these previous studies was difficult with the variability in age, demographics, and implemented pain assessment tools, postoperative pain remained the most common and long-lasting morbidity after pediatric dental rehabilitation.…”

What pain assessment guidelines tell us and what they may miss

“…A good practice point is a point that reflects 'clinical common sense ' (SIGN, 2008) and which indicates 'best clinical practice, based on the clinical experience and opinion of the guideline develop-ment committee; they are provided in situations where published evidence was insufficient to make a formal recommendation, but the committee wished to emphasize important aspects of good practice' (Howard, 2008). Without the opportunity of including 'clinical common sense' within the guidelines we would have been forced to rely solely on robust evidence and we would have missed the importance of communicating with the child.…”

“…However, guidelines can never provide a complete guide to managing a child's pain. As one of the committee members responsible for the development of the latest guidelines on 'Good Practice in Postoperative and Procedural Pain' (Howard et al, 2008) it was clear that our guidelines based on Scottish Intercollegiate Guideline Network (SIGN) methodology (2008) would have gaps. Guidelines are only ever as good as the research evidence that underpins them and, by definition, there will always be more questions to answer through research.…”

Transvers Insizyonla Laparotomi Uygulanan Çocuklarda Ultrason Kılavuzluğunda Rektus Kılıf Bloğunun Postoperatif Analjezi Üzerine Etkisi

“…Several drugs have been used for postoperative pain control such as non-steroid anti-inflammatory drugs, paracetamol and opioids with different types of applications including per oral, nasal, intravenous bolus, intravenous patientcontrolled and intravenous nurse or parentcontrolled analgesia [1][2][3] . Peripheral nerve block techniques have been frequently performed to provide pain relief after surgery.…”