H Warth1, W Astfalk, G U Walz. 1. Klinik für Anästhesiologie und Transfusionsmedizin, Universität Tübingen.
Abstract
OBJECTIVE: The application of opiates after day case surgery in childhood is discussed controversially because of possible complications. Therefore many anaesthetists try to avoid these substances and prefer peripheral analgesics for postoperative pain control. METHODS: By distributing a questionnaire concerning the arguments connected with postoperative pain to 267 parents (a total of 78.3% of the questionnaires was returned) of children that had undergone inguinal herniorrhaphy or orchidopexy we hoped to gain insight into the judgement of peripheral analgesics-in this case acetaminophen-following inguinal herniorrhaphy or orchidopexy. During standardized anaesthesia the children received acetaminophen suppositories (15-20 mg/kg BW). After release from the hospital on the same day this drug was administered by the parents in case of necessity. RESULTS: Need for analgesics was significantly higher in the group of orchidopexy than in the group of herniorrhaphy (p < .01) and even memory of pain three days after the operation seemed to be higher in this group. The sleep patterns were more influenced by orchidopexy. Surprisingly 75% of the children following herniorrhaphy received no analgesics at all after release from the hospital (6 hours postoperatively). CONCLUSION: Following herniorrhaphy the postoperative pain therapy with acetaminophen seems to be sufficient. For the postoperative pain treatment after orchidopexy additional measures like local nerve blocks, regional anesthesia or wound infiltrations with local anaesthetics should be considered.
OBJECTIVE: The application of opiates after day case surgery in childhood is discussed controversially because of possible complications. Therefore many anaesthetists try to avoid these substances and prefer peripheral analgesics for postoperative pain control. METHODS: By distributing a questionnaire concerning the arguments connected with postoperative pain to 267 parents (a total of 78.3% of the questionnaires was returned) of children that had undergone inguinal herniorrhaphy or orchidopexy we hoped to gain insight into the judgement of peripheral analgesics-in this case acetaminophen-following inguinal herniorrhaphy or orchidopexy. During standardized anaesthesia the children received acetaminophen suppositories (15-20 mg/kg BW). After release from the hospital on the same day this drug was administered by the parents in case of necessity. RESULTS: Need for analgesics was significantly higher in the group of orchidopexy than in the group of herniorrhaphy (p < .01) and even memory of pain three days after the operation seemed to be higher in this group. The sleep patterns were more influenced by orchidopexy. Surprisingly 75% of the children following herniorrhaphy received no analgesics at all after release from the hospital (6 hours postoperatively). CONCLUSION: Following herniorrhaphy the postoperative pain therapy with acetaminophen seems to be sufficient. For the postoperative pain treatment after orchidopexy additional measures like local nerve blocks, regional anesthesia or wound infiltrations with local anaesthetics should be considered.