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Pediatrics: Major Abdominal Surgery 

Pediatrics: Major Abdominal Surgery
Pediatrics: Major Abdominal Surgery
Acute Pain Medicine

Michale Sofer

, and Francis Wickham Kraemer


Following surgery, pediatric patients suffering from pain warrant consistent and frequent pain assessments. This chapter describes a variety of scales that can be used and that must be tailored to the developmental stage of the child. Examples of commonly used pediatric scales include the Neonatal Pain, Agitation and Sedation Scale (N-PASS); Face, Legs, Activity, Cry, Consolability (FLACC); Numerical Rating Scale (NRS); and the Wong Baker FACES Pain Scale. In the setting of open abdominal surgery, certain interventional techniques (continuous epidural, peripheral truncal blockade) can be used to significantly decrease pain and must be tailored to the individual patient and specific surgical subtype. Separate from interventional techniques, older children may also use patient-controlled analgesia (PCA) devices to deliver systemic opioids. For patients who are too young or are unable to press a PCA device, a variety of nurse-controlled analgesic protocols exist to deliver such systemic analgesic therapies.

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