Cause of maximum pain in hospitalized children and adolescents - A pilot project

Background

In recent years, much has been achieved in interdisciplinary cooperation concerning pain management and pain therapy with children and adolescents [1]. Key points were the age-appropriate assessment of pain at rest, on movement and maximum pain and their adequate treatment [2]. But there exist only few data concerning the reasons for maximum pain in children and adolescents [3, 4]. This pilot study investigates this issue in children and adolescents from admission to discharge.

Material and methods

For this exploratory pilot study, children and adolescents aged 11-18 years, which had a surgical intervention at the Department of Paediatric and Adolescent Surgery of the University of Graz, were interviewed by using a semi-structured interview guide. A descriptive analysis of the frequency of reported causes for the maximum pain and an examination of the relationships between the different types of surgery and the maximum pain followed.

Results

A total of 41 patients were included in this study. The most common reasons of maximum pain was the preoperative period (n = 8), followed by preoperative manual examinations (n = 4) and the first mobilization attempts postoperatively (n = 4). The most frequent and painful surgery were appendectomy (n = 9), followed by knee arthroscopy and surgeries (n = 6). Osteosyntheses of upper limb fractures were less painful.

Conclusions

The reasons for maximum pain regarding different types of surgery found in adults and children/adolescents, could be also confirmed in children and young people aged 11-18 years. The preoperative period as well as the preoperative manual examinations and the first mobilization attempts postoperatively represent new approaches for a future closer research.