Journal List > Korean J Urol > v.48(2) > 1004856

Chung, Kim, Lee, Baik, and Lee: Comparison of Pain Control Method and Assessment on Postoperative Pain in Pediatric Urological Surgery of Penoscrotal and Inguinal Regions

Abstract

Purpose

This study was designed to evaluate the effects of caudal block or/and local infiltration on postoperative pain control in pediatric patients, and whether the faces pain rating scale (FPS), visual analogue scale (VAS) or sleep disturbance scale (SDS) values were estimator dependent (parents, doctors and nurses).

Materials and Methods

Thirty four children (average age 2.8±2.4 years), undergoing inguinal and scrotal surgery, were randomly allocated to one of three groups; combined caudal block with local infiltration (group I), caudal block only (group II) and neither of the above two (group III). Parents, doctors and nurses assessed the FPS, VAS and SDS before and after surgery, and the side effects were assessed after surgery.

Results

The mean SDS, FPS and VAS values in Group III were significantly higher than those in groups I and II at 1 and 3 hours postoperatively. All patients slept with a discontented look 1 hour postoperatively, but gradually improved and normalized 12 hours postoperatively. The mean FPS and VAS values were highest 1 hour postoperatively, and decreased with time in all groups. The mean pain value, as assessed by parents, tended to be higher than those assessed by healthcare professionals - doctors and nurses, but the correlation between the parents and healthcare professionals for the SDS, FPS and VAS assessments was statistically significant (intraclass correlation coefficients; 0.64, p<0.05). There were no side effects in any patient.

Conclusions

This study suggests that caudal block with local infiltration may be more useful for postoperative pain control, and all three pain scales are useful for assessing the postoperative pain associated with pediatric urological surgery of the penoscrotal and inguinal regions.

Figures and Tables

Fig. 1
(A) Sleep disturbance scale (SDS), (B) faces pain rating scale (FPS) and (C) visual analogue scale (VAS).
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Fig. 2
Assessment of the sleep disturbance scale (SDS) by parents (A), doctors (B) and nurses (C). Group I: diamond shaped dot, group II: square shaped dot, group III: triangular shaped dot (*: p<0.05).
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Fig. 3
Assessment of faces pain rating scale (FPS) by parents (A), doctors (B) and nurses (C). Group I: diamond shaped dot, group II: square shaped dot, group III: triangular shaped dot (*: p<0.05).
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Fig. 4
Assessment of visual analogue scale (VAS) by parents (A), doctors (B) and nurses (C). Group I: diamond shaped dot, group II: square shaped dot, group III: triangular shaped dot (*: p<0.05).
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Fig. 5
Assessment of sleep disturbance scale (SDS) in groups I (A), II (B) and III (C). Parents: diamond shaped dot, doctors: square shaped dot, nurses: triangular shaped dot (p>0.05).
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Fig. 6
Assessment of faces pain rating scale (FPS) in groups I (A), II (B) and III (C). Parents: diamond shaped dot, doctors: square shaped dot, nurses: triangular shaped dot (p>0.05).
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Fig. 7
Assessment of visual analogue scale (VAS) in groups I (A), II (B) and III (C). Parents: diamond shaped dot, doctors: square shaped dot, nurses: triangular shaped dot (p>0.05).
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Table 1
The patients' demographic data
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