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Camille BOSC, Frederic Chiambaretta, Selwa Al Hazzaa, Hachemi Nezzar; Evaluation of postoperative pain and painkiller consumption after strabismus surgery, differences between adults and children. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2596.
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Post-operative pain after strabismus surgery has more often been studied to compare different antalgic drug protocols and are about the early post-operative period. Our purpose was to establish a profile of post-operative pain and drug consumption to see whether we could improve our treatment
It was a prospective descriptive non randomized study with two population: adult and children. We include 20 adults and 30 children for consecutive surgeries during one month. Surgeries were done by the same physician under general anesthesia. Pain evaluation was done with a validated visual analog scale (VAS) scores (0-10) for adults and face pain scale for children at several time. Firstly, before surgery to have a reference point. Then after wake up of anesthesia and every 3 hours during the day of the surgery. Moreover pain was evaluated three times a day the first week. Finally two evaluations were done at days 15 and day 30 after the surgery. First dose of Painkiller was given during surgery and systematically for the first day. At day one and during the first week it takes on request. The evaluation of painkiller consumption was done using the same timing that pain evaluation protocol. The data were analyzed with the nonparametric Mann-Whitney U test, p < 0.05 was considered significant.
The evolution of pain level was significantly different in the adult and children group. Adults feel statistically more pain than children mostly during the surgery day (p<0.001) and day one morning after surgery(p<0.0001). Whereas time evolution of the pain was similar in the two groups: First increase rapidly after surgery to raise a maximum 6 hours after surgery and then declines after 3 days until will be vanish. In the same way adults consume significantly more painkillers than children (p<0.0006).
Beyond the difference that seems to exist between children and adults the first days. We think that differences between adult s and children’s could found an explanation in the non-medical technics and psychological support which is gives to children. Time discordance seems to appear between pain and painkillers. A more systematic utilization of painkiller during the three first days could be more efficient. Pain evaluation seems efficient to optimize postoperative analgesia
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