Analgesia following surgery in children with and without cognitive impairment

Both children and adults with cognitive impairment (CI) have historically been excluded from research examining pain. This is unfortunate since patients with CI may be at higher risk for experiencing pain or having their pain undertreated due to the difficulty of pain assessment and communication. There are now several published reports about the general pain experience of both adult and pediatric patients with cognitive impairment. The purpose of this study was to compare the amount and type of pain medication administered in children with and without Cl after surgery to ascertain if there were any differences in analgesic administration patterns between these two groups. One hundred and fifty-two children with borderline to profound Cl and 138 non impaired (NI) children were recruited to participate. Analgesic administration data include type and amount of opioid, type of non-opioid medication, and prescribed discharge medications. Results of this study show that children with Cl undergoing surgery received less opioid in the perioperative period than children without Cl. However, children with Cl received comparable amounts and types of analgesics in the postoperative period as children without Cl. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.