Postoperative analgesia in children

In many centres for pediatric surgery too many children still experience intense postoperative pain. Factors that contribute to inadequate postoperative pain control in children are: lack of the experience, inadequate use of pain scales, interpatient variability in pain perception and analgesic requirements, differences in pharmacodynamics and pharmacokinetics, age restricted drug licensing and a relative paucity of researches. The proper pain estimation scales are dependent on the child's age and their understanding of pain and of the scale. Most commonly used drugs in pediatric postoperative pain relief are opioid and nonopioid analgesics (nonsteroidal anti-inflammatory drugs, paracetamol, metamizole, ketamine, Dexamethasone and Alpha-2-agonists). The use of regional anesthesia techniques is becoming increasingly popular in postoperative analgesia following pediatric surgery. Severe acute postoperative pain in children can have significant long term effects such as chronic pain. Of great importance is that acute postoperative pain in children is optimally managed from the outset.