Encyclopedia of Pain

2007 Edition

Acute Pain in Children, Post-Operative

  • Jolene D. Bean-Lijewski
Reference work entry
DOI: https://doi.org/10.1007/978-3-540-29805-2_69


Pediatric Post-Surgical Pain; Acute Post-Operative Pain in Children


Children who have surgery experience significant postoperative pain for several days. Appropriate pain management should be initiated in the immediate post-operative period and continue until the pain resolves, whether the child is at home or in the hospital. Surgical trauma results from tissue destruction and musculoskeletal strain that causes the release of vaso- and immuno-reactive substrates that promote inflammation, hyperpermeability and pain.

Ineffective pain management increases the incidence of postoperative behavioral disorders in children and the risk of developing persistent or neuropathic pain. In preterm infants and neonates, this effect may be compounded by the lack of descending inhibitory pathways and enhanced neuroplasticity resulting in more extensive, persistent effects (Tachibana et al. 2001). Despite advances in the management of post-operative pain, nearly 70% of patients...

This is a preview of subscription content, log in to check access.


  1. 1.
    Apfelbaum JL, Chen C, Mehta SS et al. (2003) Postoperative pain experience: results from a national survey suggest postoperative pain continues to be under managed. Anesthe Analg 97:534–40Google Scholar
  2. 2.
    Bremerich DH, Neidhart G, Heimann K et al. (2001) Prophylactically administered rectal acetaminophen does not reduce postoperative opioid requirements in infants and small children undergoing elective cleft palate repair. Anesth Analg 92:907–912Google Scholar
  3. 3.
    Bozkurt P (2002) The analgesic efficacy and neuroendocrine response in paediatric patients treated with two analgesic techniques: using morphine-epidural and patient-controlled analgesia. Paed Anes 12:248–254Google Scholar
  4. 4.
    Farrar, MW, Lerman J (2002) Novel concepts for Analgesia in Pediatric Surgical Patients: cyclo-oxygenase-2 Inhibitors, alpha-2 agonists and opioids. Anes Clin NA 20:59Google Scholar
  5. 5.
    Gan TJ, Joshi GP, Viscusi E et al. (2004) Preoperative parenteral parecoxib and follow-up oral valdecoxib reduce length of stay and improve quality of patient recovery after laparoscopic cholecystectomy surgery. Anesth Analg 98:1665-1673Google Scholar
  6. 6.
    Greenberg RS, Billet C, Zahurak M et al. (1999) Videotape increases parental knowledge about pediatric pain management. Anesth Analg 89:899–903Google Scholar
  7. 7.
    Huth MM, Broome ME, Good M (2004) Imagery reduces children’s post-operative pain. Pain 110:439–448Google Scholar
  8. 8.
    Kokinsky E, Thornbert E (2003) Postoperative pain control in children. A guide to drug dose. Paediatr Drugs 5:751–762Google Scholar
  9. 9.
    Kokki, Hannu (2003) Nonsteroidal anti-inflammatory drugs for postoperative pain. A focus on children. Paediatr Drugs 5:103–123Google Scholar
  10. 10.
    Korpela R, Korvenoja P, Meretoja OA (1999) Morphine-sparing effect of acetaminophen in pediatric day case surgery. Anesthesiol 91:442–447Google Scholar
  11. 11.
    Kost Byerly S (2002) New concepts in acute and extended postoperative pain management in children. Anesthesiol Clin North America 20:115–135Google Scholar
  12. 12.
    Krane EJ, Dalens BJ, Murat I et al. (1998) The safety of epidurals placed under general anesthesia. Reg Anesth Pain Med 23:433–438Google Scholar
  13. 13.
    McNeely JK, Trentadue NC (1997) Comparison of patient-controlled analgesia with and without nighttime morphine infusion following lower extremity surgery in children. J Pain Symptom Manage 13:268–273Google Scholar
  14. 14.
    Tachibana T, Ling QD, Ruda MA (2001) Increased Fos induction in adult rats that experienced neonatal peripheral inflammation. Neuroreport 12:925–927Google Scholar
  15. 15.
    Watcha MF, Issioui T, Klein KW et al. (2003) Costs and effectiveness of rofecoxib, celecoxib and acetaminophen for preventing pain after ambulatory otolaryngologic surgery. Anesth Analg 96:987–994Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • Jolene D. Bean-Lijewski
    • 1
  1. 1.Department of AnesthesiologyScott and White Memorial HospitalTempleUSA