Perioperative pain management in children

Perioperative paediatric pain management is a major medical challenge that necessitates collaboration with surgical colleagues. Pre-emptive postoperative pain treatment can be planned already during the surgical procedure. The intensity of postoperative pain should be measured on a regular basis with the aid of observational scales in the recovery room, intensive care unit or ward. On the basis of the outcome of pain measurement, analgesics should be administered in accordance with internal standards. Non-opioid analgesics such as ibuprofen or metamizole may be used for moderate pain, while paracetamol, due to its potential side effects and low analgesic properties, no longer has an important role in postoperative pain relief. Such opioids as piritramide, nalbuphine, morphine and tramadol are recommended for acute and severe postoperative pain. Local anaesthesia should be applied whenever possible. The approach to pain management should be multimodal involving a combination of all analgesic techniques.