For children, adequate perioperative pain management is a right according to the UN convention on the rights of the child, a law in Sweden since 2020. Despite this, children are still under-treated in many cases. In addition to great suffering, this can lead to missing school and a long-term burden on the society. ESPA, the European Society for Pediatric Anesthesia, has drawn up guidelines for perioperative pain management. With the study 4P: Persistent Postoperative Pediatric Pain, we want to investigate whether these guidelines are followed and how many children develop long-term pain postoperatively. In order to map the prevalence of pain after surgery in children in Sweden, the investigators plan to include and follow 2000 children in southern Sweden who undergo surgery. The study provides a unique opportunity to follow a large number of children, evaluate given per- and postoperative pain treatment and identify factors linked to the development of acute and long-term postoperative pain. Our goal is to optimize peri- and postoperative pediatric pain management to promote rapid recovery after surgery.
Study Type
OBSERVATIONAL
Enrollment
1,000
All subjects will be exposed to surgery
Queen Silvias Childrens Hospital Sahlgrenska University Hospital
Gothenburg, Sweden
Hallands Hospital Halmstad
Halmstad, Sweden
Helsingborgs Hospital
Helsingborg, Sweden
Lund childrens hospital
Lund, Sweden
Incidence of acute postoperative pain
How many children experience acute postoperative pain after surgery in Sweden?
Time frame: Within 24 hours after surgery
Adherence to guidelines from ESPA regarding perioperative analgesia
How many patients are treated according to the suggested guidelines regarding pain treatment from ESPA (%)? Do they experience less postoperative pain (FLACC/FPS/NRS 0-10)? Groups compared with MannWhitney U-test. Also description of the deviation.
Time frame: Perioperative
Incidence of persistent postoperative pain
How many children experience persistent postoperative pain after surgery in Sweden?
Time frame: At 3 months after surgery
Incidence of persistent postoperative pain
How many children experience persistent postoperative pain after surgery in Sweden?
Time frame: At 6 months after surgery
Incidence of persistent postoperative pain
How many children experience persistent postoperative pain after surgery in Sweden?
Time frame: At 1 year after surgery
Do regional blocks influence the level of acute postoperative pain?
Do children who recieve a regional block experience less postoperative pain? Croups compared with MannWhitney U-test.
Time frame: Acute - within 24 hours.
Do regional blocks influence the level of persistent pain?
Do children who recieve a regional block experience less postoperative pain? Croups compared with MannWhitney U-test.
Time frame: 3 months after surgery
Parental stress
Does the subjective level of stress, measured on a scale from 0-10 by the parents, affect the experience of acute postoperative pain? Correlation between pain (FLACC/FPS/NRS depending on age) correlated to subjective stress using Spearman Rho.
Time frame: Within 24 hours
Parental stress
Does the subjective level of stress, measured on a scale from 0-10 by the parents, affect the experience of persistent postoperative pain? Correlation between pain (FLACC/FPS/NRS depending on age) correlated to subjective stress using Spearman Rho.
Time frame: 3 months after surgery
Age
Which age-groups experience most pain. Pain evaluated with FLACC/FPS/NRS depending on age. Risk evaluated with logistic regression.
Time frame: Acute (24 hours) and persistent (3,6 months and 1 year)
Gender
Do girls experience more pain than boys? Pain evaluated with FLACC/FPS/NRS depending on age. Risk evaluated with logistic regression.
Time frame: Acute (24 hours) and persistent (3,6 months and 1 year)
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