Postoperative Pain in Children After Dentistry Under General Anesthesia

Anesth Prog. 2015 Winter;62(4):140-52. doi: 10.2344/14-27.1.

Abstract

The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.

Keywords: Anesthetic; Assessment; Children; Postoperative pain.

MeSH terms

  • Anesthesia Recovery Period
  • Anesthesia, Dental / methods*
  • Anesthesia, General / methods*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Child
  • Child Behavior
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ibuprofen / therapeutic use
  • Male
  • Pain Measurement / methods
  • Pain, Postoperative / etiology*
  • Parent-Child Relations
  • Prospective Studies
  • Pulpectomy / methods
  • Pulpotomy / methods
  • Time Factors
  • Tooth Extraction / methods
  • Tooth, Deciduous / surgery

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen