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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 13 (2003), S. 0 
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The faces pain scales are often used for self-report assessment of paediatric pain. The aim of this study was to evaluate the validity of a six-graded faces pain scale after surgery by comparing the level of agreement between the children's report of faces pain scores and experienced nurses’ assessment of pain by observation of behaviour. The faces pain scores before, at and after administration of analgesics were analysed. The study was performed in two South African hospitals, one with a mainly rural population and the other with an urban population.Methods: A total of 110 children aged 4–12 years, scheduled for inguinal surgery in the two South African hospitals, were included in the study. The anaesthetic technique was standardized. All patients received a caudal block preoperatively. Postoperative pain assessments were made every hour for 8 h after the caudal block was performed. A designated nurse assessed pain by using a four-graded descriptive scale (no, mild, moderate or severe pain) and thereafter the child reported pain by using the six-graded faces pain scale.Results: A high correlation was found between the two methods of assessment (τ = 0.76, P 〈 0.0001). The correlation between methods was high in both hospital populations and in all age groups. The weakest correlation was found in children aged 8–12 years (τ = 0.56, P 〈 0.01). Significantly lower faces pain scores were found after administration of analgesics compared with pain rating before analgesics (P 〈 0.0001). The proportion of patients with pain scores above 2 decreased from 86% to 31% (P 〈 0.001).Conclusions: The findings support this six-graded faces pain scale as a useful and valid instrument for measuring pain in the postoperative period in children aged 4–12 years.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Pediatric anesthesia 9 (1999), S. 0 
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Postoperative conditions in hospital and at home were evaluated in 200 paediatric daycase patients by using questionnaires and telephone interviews. Pain was assessed by behaviour observation or a faces rating scale depending on age. Anaesthetic methods, nausea/vomiting, analgesics and parents’ aspects were also recorded. Seventy per cent of the patients received regional anaesthesia. Immediate postoperative analgesia was satisfactory in 75% of the children. When the effects of intraoperatively administered analgesics wore off at home almost half the children rated higher than mild pain. The increased degree of pain at home was especially pronounced after regional anaesthesia. The total incidence of nausea/vomiting was 28% and fentanyl caused nausea and vomiting in a significantly higher proportion of cases. The study points out that immediate postoperative comfort obtained by prophylactic analgesia needs to be followed by analgesics given on a continuous basis for the first days after surgery.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The use of opioids is known to increase the incidence of postoperative nausea and vomiting (PONV). In spite of this, administration of low doses of an opioid during anaesthesia is common practice, even if a regional anaesthetic technique is used. This study was designed to estimate the effects of intraoperative intravenous administration of fentanyl on PONV in paediatric daycase surgery. Methods: PONV and pain were evaluated in 29 boys during the first 24 h after daycase penile surgery. Anaesthesia was standardized. The patients were allocated to two groups. Fentanyl 1 µg·kg−1 i.v. or placebo was administered in a randomized, double-blind design. A caudal block with ropivacaine 2 mg·ml−1, 0.5 ml·kg−1 was performed preoperatively and topical lidocaine gel 20 mg·ml−1 was applied over the wound area immediately after surgery. Results: The total incidence of PONV in hospital and at home during the first 24 h was 36% (5/14) when fentanyl was used, whereas no PONV was reported when placebo was given (P 〈 0.05). The median time to first administration of analgesics after the caudal block was approximately 6 h. It did not differ between groups. Intraoperative fentanyl did not result in any reduction in pain scores nor the incidence of pain. Fentanyl caused apnoea in one-half of the cases and decreased the breathing rates during the first 10 min of surgery. Conclusions: Intraoperative use of i.v. fentanyl 1 µg·kg−1 combined with a regional anaesthetic block is associated with an increased incidence of PONV without any significant contribution to the postoperative pain relief.
    Type of Medium: Electronic Resource
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