Postoperative pain after spinal surgery in the paediatric population

Abstract

Background: Postoperative pain is a major after-effect of surgery. Especially severe pain occurs after extensive operations on the spine. The goal of the study was to investigate the laboratory predictive factors of intense postoperative pain in children undergoing extensive surgery Methods: We recruited 41 children, median age 13 years (IQR: 10-15 years) undergoing extensive spinal surgery. The subjects were divided into two groups based on the intensity of postoperative pain measured using the 10-point numerical rating scale (NRS), visual analogue scale (VAS) or Faces Pain Scale-Revised (FPS-R). Patients with a score of 5 or higher were included in the study group while those with an NRS score of less than 5 were included in the control group. We collected detailed clinical and laboratory data before, during and after surgery. Results: The highest intensity of pain was observed in the first 6 hours after surgery. Postoperative pain was associated with a greater drop in the haemoglobin concentration and haematocrit level in the peri-operative period (P = 0.006 and P = 0.019, respectively), as well as increases in mean arterial pressure during surgery. Additionally, we found that children with intense pain had a higher total protein concentration after surgery. Conclusions: We reported that the decrease in haemoglobin and haematocrit levels, fluctuations in mean arterial pressure, as well as the total protein concentration, could be useful prognostic factors of early postoperative pain. Anaesthesiology Intensive Therapy 2018, vol. 50, no 4, 252-258.