Postoperative pain in small-for-gestational age infants after hernia repair, orchidopexy and urethral reconstruction surgery: A pilot study. (September 2019)

• Record Type: Journal Article
• Authors: Schüssler, Stephanie C.; Kußmann, Franziska; Fahlbusch, Fabian B.; Münster, Tino; Hirsch, Karin; Carbon, Roman; Albrecht, Sven; Dötsch, Jörg; Rascher, Wolfgang
• Is Part Of: Early human development. Volume 136(2019)
• Page Start: 39
• Page End: 44
• Publication Date: 2019-09
• Subjects: Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2019.07.003
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: Small-for-gestational-age (SGA) birth bears an enhanced risk of developing hypertension, obesity, insulin resistance and mental health disorders in later life as a consequence of adaptive processes in utero. Only a small number of studies on pain perception in SGA infants exist. These are indicative of a blunted stress response to pain in SGA newborns. Aim: We initiated a pilot study investigating differences in postoperative pain perception between SGA and appropriate-for-gestational-age (AGA) infants. Methods: Pain and alertness levels of 10 formerly SGA and 14 AGA infants at the age 0.5–2 years were evaluated by the FLACC scale, Steward and Aldrete Scores following hernia repair, reconstructive surgery of hypospadia and orchidopexy. In addition, the postoperative consumption of non-steroidal anti-inflammatory drugs was compared between SGA and AGA. Results: Postoperative pain and alertness levels were not significantly different in SGA and AGA children. We did not observe significant group differences regarding the consumption of non-steroidal anti-inflammatory drugs. Conclusion: While previous studies were suggestive of a suppressed stress response to pain in SGA newborns, these findings did not fully translate into an altered response to pain beyond the newborn age. Further studies in a larger cohort seem necessary to verify this finding. Graphical abstract: Postoperative pain and the demand for analgesics did not differ between small-for gestational age and appropriate-for-gestational age infants.Unlabelled Image Highlights: This is the very first study about postoperative pain in small-for-gestational (SGA) infants. Postoperative pain was assessed by the FLACC pain scale and the demand of analgesics. We found no significant difference between SGA and AGA infants.