scholarly journals Pulsed Radiofrequency of the Occipital Nerves: Results of a Standardized Protocol on Chronic Headache Management

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Chrysanthi Batistaki ◽  
Alia Ibrahim Madi ◽  
Agathi Karakosta ◽  
Georgia Kostopanagiotou ◽  
Chrysa Arvaniti
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Chronic Headache ◽  
Rating Scale ◽  
Pulsed Radiofrequency ◽  
Open Label ◽  
Standardized Protocol ◽  
Headache Management ◽  
Chronic Headaches ◽  
Tension Type Headaches

Background: Pulsed radiofrequency (PRF) of the occipital nerves has neuromodulative properties and is used for chronic pain management. However, its role in various types of chronic headaches has not been adequately investigated so far. Objectives: Τhis was an observational, open-label, prospective study aiming to assess the efficacy of PRF of occipital nerves on various types of chronic headache management. Methods: Patients with chronic headaches followed up at the pain management unit were scheduled for PRF of both occipital nerves after a positive diagnostic nerve block. PRF was applied following a standardized protocol at 42°C, and the number of headaches per month was assessed as a primary outcome at baseline (before treatment), as well as after 1, 3, and 6 months. Pain intensity during headache crises was recorded using the Numeric Rating Scale (NRS, 0 - 10), Results: Fifty-seven patients suffering from chronic migraines, cluster headaches, tension-type headaches, and occipital neuralgia were studied. PRF significantly improved the number of headache episodes per month, as well as the pain intensity of the crises. The median number of headache episodes per month was significantly reduced in patients with migraine, from 14.5 to 4 after 1 month, and to 6.5 after 6 months. The same was seen for patients with clusters, who were also improved. A statistically significant reduction in NRS values over time was seen for all types of headaches. Conclusions: PRF of the occipital nerves can lead to a reduction of the number of headache episodes per month, improving the intensity of pain during each episode.

Circle therapy for headache management: case studies

2020 ◽  
Vol 24 (1) ◽  
pp. 101-104
Author(s):  
Muhammad Rafiq
Keyword(s):  
Pain Intensity ◽  
Case Studies ◽  
Rating Scale ◽  
Psychological Pain ◽  
Current Case ◽  
Paired Samples ◽  
Subjective Pain ◽  
Headache Management ◽  
Test Use ◽  
Pain Rating Scale

Recent findings have indicated that hypnotic interventions produce significant decrease in pain intensity. This current case studies are focused to highlight significant impact on pain management including headache. All the patients underwent a complete observation and clinical interview and only patients with psychological pain were included in the study group. For the management of headache, a novel hypnotic intervention - Circle Therapy (CT), was applied on a group of ten patients indicating their pain intensity in the range of 8-10 on subjective pain rating scale. According to rating scale, headache above 8 was considered as severe, 5-8 moderate and < 5 as mild.  CT is a brief hypnotic technique limited to about 10 min. Post hypnosis ratings were also measured. The pre and post hypnosis data were recorded and analyzed by paired samples t test. Use of CT showed significant results between pre and post rating e.g. 9 ± 0.25 vs. 1 ± 0.21 (p < 0.001). This brief CT intervention provided an immediate relief from headache, however, this is limited to few case studies focusing on just headache. So, we recommend large sample studies to document the effects of CT in different types of pain. Citation: Rafiq M. Circle therapy for headache management: case studies. Anaesth pain intensive care 2020;24(1):__ DOI: https://doi.org/10.35975/apic.v24i1. Received – 28 December 2019; Reviewed – 10 January 2020; Accepted - 10 January 2020;

scholarly journals Pre-Hospital Pain Management in Children with Injuries: A Retrospective Cohort Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3056
Author(s):  
Ada Holak ◽  
Michał Czapla ◽  
Marzena Zielińska
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Pain Assessment ◽  
Rating Scales ◽  
Rating Scale ◽  
Low Frequency ◽  
Numeric Rating Scale ◽  
Health Concern ◽  
School Age Children ◽  
Medical Teams

Background: The all-too-frequent failure to rate pain intensity, resulting in the lack of or inadequacy of pain management, has long ceased to be an exclusive problem of the young patient, becoming a major public health concern. This study aimed to evaluate the methods used for reducing post-traumatic pain in children and the frequency of use of such methods. Additionally, the methods of pain assessment and the frequency of their application in this age group were analysed. Methods: A retrospective analysis of 2452 medical records of emergency medical teams dispatched to injured children aged 0–18 years in the area around Warsaw (Poland). Results: Of all injured children, 1% (20 out of 2432) had their pain intensity rated, and the only tool used for this assessment was the numeric rating scale (NRS). Children with burns most frequently received a single analgesic drug or cooling (56.2%), whereas the least frequently used method was multimodal treatment combining pharmacotherapy and cooling (13.5%). Toddlers constituted the largest percentage of patients who were provided with cooling (12%). Immobilisation was most commonly used in adolescents (29%) and school-age children (n = 186; 24%). Conclusions: Low frequency of pain assessment emphasises the need to provide better training in the use of various pain rating scales and protocols. What is more, non-pharmacological methods (cooling and immobilisation) used for reducing pain in injured children still remain underutilized.

scholarly journals Multimodal Analgesia in Perioperative Settings: Improvement Perspectives / Multimodāla Analgēzija Perioperatīvajā Periodā: Uzlabošanas Iespējas

2014 ◽  
Vol 68 (5-6) ◽  
pp. 222-227
Author(s):  
Iveta Golubovska ◽  
Aleksejs Miščuks ◽  
Ēriks Rudzītis
Keyword(s):  
Pain Management ◽  
Lower Extremity ◽  
Pain Intensity ◽  
Severe Pain ◽  
Rating Scale ◽  
Multimodal Analgesia ◽  
Numeric Rating Scale ◽  
Plexus Brachialis ◽  
Single Shot ◽  
Maximum Pain

Abstract The aim of this study was to evaluate the intensity of pain in orthopaedic hospital patients and to identify unsatisfactory pain management and possibilities for improvements in the future. Data collection included Numeric Rating Scale (NRS) scores, which characterised the intensity of pain. Maximum pain on the day of surgery, mean pain on the day of surgery (D0), and mean pain on first (D1) and second (D2) postoperative days were documented. The pain of an intensity from 0 to 3 was defined as mild pain, 4 to 6 as moderate pain, and 6 to 10 as severe pain. Maximum severe pain intensity on the day of surgery was experienced by 20.5% of patients, moderate by 45.8%, and mild by 33.6%. The reported mean pain intensity according to type of surgery was as follows: hip replacement- 2.79 ± 1.6 (D0), 2.09 ± 1.4 (D1), and 1.35 ± 1.2 (D2); knee replacement - 3.39 ± 1.7 (D0), 2.98 ± (D1), 1.82 ± 1.36, and (D2); upper extremity surgery - 3.59 ± 1.9 (D0), 3.4 ± 1.7 (D1), and 2.1 ± 1.5 (D2); lower extremity surgery - 4.1 ± 2.1 (D0), 3.49 ± 1.42 (D1), and 2.58 ± 1.4 (D2); spine surgery - 3.31 ± 1.58 (D0), 2.88 ± 1.96 (D1), and 1.83 ± 1.74 (D2). Patients in the lower extremity group experienced unacceptable mean pain. The maximum pain intensity on day of surgery was experienced by patients after single-shot plexus brachialis block anaesthesia (5.24 ± 2.4). Well-designed multimodal analgesia with special attention to single shot techniques may improve pain management and functional outcomes after orthopaedic surgery.

scholarly journals Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care

2019 ◽  
Vol 79 (2) ◽  
pp. 276-284 ◽  
Author(s):  
Edward Roddy ◽  
Kris Clarkson ◽  
Milica Blagojevic-Bucknall ◽  
Rajnikant Mehta ◽  
Raymond Oppong ◽  
...  
Keyword(s):  
Primary Care ◽  
Pain Intensity ◽  
Primary Outcome ◽  
Low Dose ◽  
Rating Scale ◽  
Randomised Trial ◽  
Pragmatic Trial ◽  
Open Label ◽  
Gout Flare ◽  
Gout Flares

ObjectivesTo compare the effectiveness and safety of naproxen and low-dose colchicine for treating gout flares in primary care.MethodsThis was a multicentre open-label randomised trial. Adults with a gout flare recruited from 100 general practices were randomised equally to naproxen 750 mg immediately then 250 mg every 8 hours for 7 days or low-dose colchicine 500 mcg three times per day for 4 days. The primary outcome was change in worst pain intensity in the last 24 hours (0–10 Numeric Rating Scale) from baseline measured daily over the first 7 days: mean change from baseline was compared between groups over days 1–7 by intention to treat.ResultsBetween 29 January 2014 and 31 December 2015, we recruited 399 participants (naproxen n=200, colchicine n=199), of whom 349 (87.5%) completed primary outcome data at day 7. There was no significant between-group difference in average pain-change scores over days 1–7 (colchicine vs naproxen: mean difference −0.18; 95% CI −0.53 to 0.17; p=0.32). During days 1–7, diarrhoea (45.9% vs 20.0%; OR 3.31; 2.01 to 5.44) and headache (20.5% vs 10.7%; 1.92; 1.03 to 3.55) were more common in the colchicine group than the naproxen group but constipation was less common (4.8% vs 19.3%; 0.24; 0.11 to 0.54).ConclusionWe found no difference in pain intensity over 7 days between people with a gout flare randomised to either naproxen or low-dose colchicine. Naproxen caused fewer side effects supporting naproxen as first-line treatment for gout flares in primary care in the absence of contraindications.Trial registration numberISRCTN (69836939), clinicaltrials.gov (NCT01994226), EudraCT (2013-001354-95).

scholarly journals Characterization of  self-anticipated surgical pain prior to general anesthesia - a prospective observational study

2021 ◽  
Author(s):  
Wei-Shu Chang ◽  
Yi-Ting Hsieh ◽  
Moa-Chu Chen ◽  
Shu-Ching Chang ◽  
Tzu-Shan Chen ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Observational Study ◽  
General Anesthesia ◽  
Pain Intensity ◽  
Pain Score ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Perioperative Period ◽  
Pain Scores

Abstract Background: Current postoperative pain management principles are primarily based on the type and extent of surgical interventions. This clinical study measured patient’s self-anticipated pain score before surgery and compared the scores with the pain levels and analgesic requirements after surgery.Methods: This prospective observational study recruited consecutive patients who received general anesthesia for elective surgeries in E-Da Hospital (Taiwan) between June and August 2018. Patients were asked to subjectively rate their highest anticipated pain level (numerical rating scale, NRS 0-10) for their scheduled surgical intervention during their preoperative anesthesia assessment. After the operation, the actual pain intensity (NRS 0-10) experienced by the patient in the post-anesthesia care unit (PACU) and the total dose of opioids administered during the perioperative period were recorded. Pain scores ³4 on the NRS were regarded as being unacceptable levels of anticipated or postoperative pain.Results: A total of 857 patients were included in the study. The final database included 49.2% males, and 73.7% of them have had previous operations. The mean anticipated pain score was 4.9±2.5 and 72.2% of the patients reported an anticipated NRS ³4 before their operations. Females anticipated significantly higher overall pain intensities than male patients (adjusted odds ratio 1.695, 95% confidence interval 1.252-2.295; P=0.001). Patients over 40 years of age reported significantly lower overall anticipated NRS scores (4.78±2.49 vs 5.36±2.50; P=0.003). Patients scheduled to receive more invasive surgical procedures were more likely to anticipate high pain intensity in the preoperative period (P<0.001). Higher anticipated pain scores (preoperative NRS³4) were associated with higher actual postoperative pain levels (P=0.032) in the PACU and higher total equivalent opioid use (P=0.001) for acute pain management during the perioperative period.Conclusion: This observational study found that females, younger patients (£40 years), and patients scheduled for more invasive surgeries anticipate significantly higher surgery-related pain. Therefore, appropriate preoperative counseling for analgesic control and management of exaggerated pain expectation in these patients are necessary to improve the quality of anesthesia delivered and patient’s satisfaction.

scholarly journals PAIN AND HEMODYNAMIC STATUS ASSESSMENT IN CHILDREN UNDERGOING ORTHOPAEDIC TRAUMA SURGERIES AMID PERIOPERATIVE MULTIMODAL ANALGESIA

2021 ◽  
Vol 1 (7(71)) ◽  
pp. 22-25
Author(s):  
M. Gomon ◽  
O. Goncharuk
Keyword(s):  
Blood Glucose ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Orthopaedic Trauma ◽  
Hemodynamic Parameters ◽  
Hemodynamic Assessment

Stable hemodynamic parameters are used as one of the criteria for adequacy of analgesia during the surgery. In order to provide reliable antinociceptive protection, it is necessary to reduce the flow of nociceptive stimuli from the peripheral to central receptors. Hence, pain and hemodynamic assessment is crucial for adequate perioperative analgesia and the choice of anesthetic technique in children undergoing orthopaedic trauma surgeries.  Purpose. This study aims to assess pain intensity and changes of hemodynamic parameters in orthopaedic trauma pediatric patients under perioperative multimodal analgesia. Materials and methods. A total of 61 patients with orthopaedic trauma were included in this study. Mean age was 9.3±4.5 years (range: 8-17). Open reduction was performed in 43 cases (70.5%), and 18 children (29.5%) underwent closed reduction. Mean duration of the surgery was 102.1±20.4 min. All patients have the premedication (atropine sulfate, diazepam, acetaminophen, intravenously) done 30-40 min. before the surgery in the surgical ward. Surgical procedures were performed under general anesthesia. Postoperative pain intensity was assessed by Individualized Numeric Rating Scale – NRS. Perioperative monitoring included peripheral pulse oximetry (SpO2), non-invasive blood pressure measurement (SBP, DBP, MAP), vital signs and blood glucose level control. Postoperative analgesia was maintained by IV acetaminophen, if necessary – by administration of divided dose of morphine. Results and conclusions. Mean pain intensity was 2.32±0.28 (6 hrs postop.), 12.06±0.16 (12 hrs postop.), 2.78±0.24 (24 hrs postop.), 2.04±0.6 (48 hrs postop.) based on NRS, respectively (p<0.05). 26% patients required single dose administration of morphine during the first 24 hrs after the surgery. Significant decrease in blood glucose 12 hrs (4.3 mmol/l) and 24 hrs (4.6 mmol/l) after the surgery in comparison to the preoperative level (6.2 mmol/l) suggests of the severe stress resolution in the majority of the patients and adequate pain management. Preoperative stress is mainly caused by underlying disease and the surgical procedure itself. Heart rate (HR) monitoring shows that the vast majority of the patients (n=55, 86.5%) had mean pulse less than 110 bpm after IV Acetaminophen administration (20 mg/kg).  Minimal mean HR throughout the study was 87.3±5.3 bpm, maximal mean HR was 120±5.3 bpm. Mean SBP throughout the study was 100.2±5.3 mm Hg and mean DBP – 66.4±1.8 mm Hg, respectively. Oxygen saturation was within normal limits in all children. Hemodynamic parameters were within physiological surgical stressrelated limits, which suggests of the fluctuant course of postoperative pain syndrome. A traditional approach to perioperative pain management in children is associated with a moderate pain syndrome according to the results obtained with pain scales, hyperkinetic type of hemodynamics 6.24 hrs after the surgery, and the fluctuant course of postoperative pain.

OUTCOME OF OCCIPITAL NERVE BLOCK IN PATIENTS WITH CHRONIC HEADACHES

2021 ◽  
pp. 53-54
Author(s):  
Nabarun Gupta ◽  
Saumen Kumar De
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Nerve Blocks ◽  
Occipital Nerve ◽  
Longitudinal Outcome ◽  
Occipital Nerve Block ◽  
Chronic Headaches ◽  
Tension Type Headaches ◽  
Cluster Headaches ◽  
Prospective Longitudinal

Background: Chronic headaches are very prevalent affecting a sizable number of global populations. Occipital nerve block (OCN) can help them relieve their pain and get back to their normal life. Conditions that are treated with occipital nerve blocks include: Chronic migraine, Episodic migraine, Chronic cluster headaches, Episodic cluster headaches, Tension-type headaches, Occipital neuralgia. These may include types of pain that start at the back of the head near the neck, and then radiate outward throughout the skull. Occipital nerve block is a minimally invasive intervention, inhibits or blocks the disproportionate or chronic signals that are sent to the brain, processed and perceived as headache pain, resulting in pain relief lasting up to several months. It is our humble approach to see the effectiveness of this mode of minimal intervention. Objectives: The aim was to see the effectiveness of Occipital Nerve Block in patients of Chronic headaches. Place of study: Dept of PMR, IPGME & R and SSKM Hospital, Kolkata Period of study: 1 st. September, 2017 to 31 st. August, 2018. (12 months) Study pattern: Prospective Longitudinal Outcome Study Methods: After getting Institutional Ethical Committee clearance a total number of 98 patients with Chronic headaches who did not respond with conservative management were included. Patients with other causes of headache, patients with diabetes, severe hypertension, otherwise th th th contraindicated for injections, are excluded. Occipital nerve blocks performed to patients and were evaluated initially and at the 4 , 8 , and 12 week followed up using Numeric Pain Rating Scale (NPRS). Adverse events and patient satisfaction were recorded, number of attacks pre 4wks and after intervention. Results: Statistically signicant improvement is seen in these patients treated with Occipital Nerve Block Conclusions: Occipital Nerve Block effective mode of management in patients with Chronic headaches and may be recommended to patients with moderate to severe chronic pain that has not responded to conventional treatment such as oral painkillers or lifestyle interventions.

scholarly journals Intravenous Oxycodone versus Intravenous Morphine in Cancer Pain: A Randomized, Open-Label, Parallel-Group, Active-Control Study

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Kyung-Hee Lee ◽  
Jung-Hun Kang ◽  
Ho-Suk Oh ◽  
Moon-Ki Choi ◽  
Byoung-Yong Shim ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Adverse Events ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Efficacy And Safety ◽  
Open Label ◽  
Patients With Cancer ◽  
Average Pain Intensity ◽  
Average Pain

Objective. To compare efficacy and safety of intravenous continuous infusion of oxycodone with morphine in patients with cancer pain.Methods. A 5-day, randomized, open-label, exploratory study at 6 sites in the Republic of Korea. Sixty-six adults aged ≥19 years with moderate-to-severe cancer pain (Numeric Rating Scale [NRS] ≥ 4) were enrolled. The study group received intravenous (IV) oxycodone, and the comparator group received IV morphine which were titrated depending on pain intensity. The efficacy endpoint is change in average NRS score from baseline to Day 5. Other assessments included worst, current, and average pain intensity; patient satisfaction; medication dose; and adverse events.Results. Both groups achieved >50% reduction in average pain intensity: from “moderate” at baseline (oxycodone versus morphine: 6.0 ± 1.8 versus 5.9 ± 1.4) to “mild” at Day 5 (2.5 ± 1.8 versus 2.8 ± 1.6). While this reduction was similar between groups (3.5 ± 2.2 versus 3.1 ± 1.8,Pvalue = 0.562), oxycodone achieved faster pain relief (average pain: 3.0 ± 1.6 versus 3.9 ± 1.6,Pvalue = 0.020) on Day 2 and significant NRS reductions for worst pain on Day 2 (Pvalue = 0.045) and current pain on Day 2 (Pvalue = 0.035) and Day 5 (Pvalue = 0.020) compared to morphine. Patient satisfaction, adverse events, and adverse drug reactions were similar for both groups.Conclusions. For Asian patients with cancer pain, IV oxycodone is faster acting and showed similar analgesic efficacy and safety profiles as IV morphine. This trial is registered with Clinicaltrials.govNCT02660229.

scholarly journals Oral oxycodone for pain after caesarean section: A randomized comparison with nurse-administered IV morphine in a pragmatic study

2015 ◽  
Vol 7 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Boel Niklasson ◽  
Catarina Arnelo ◽  
Susanne Georgsson Öhman ◽  
Märta Segerdahl ◽  
Agneta Blanck
Keyword(s):  
Caesarean Section ◽  
Pain Intensity ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Oral Treatment ◽  
Standard Of Care ◽  
Adverse Outcomes ◽  
Open Label ◽  
Serious Adverse Events

AbstractBackground and aims The present randomized open label parallel group study was conducted to evaluate if an oral oxycodone (OXY) regimen can be at least equally effective and as safe for postoperative analgesia after caesarean section (CS) as a standard of care program using nurse-administered intravenous morphine (IVM), followed by oral codeine.MethodsEighty women (40 + 40) were scheduled for elective CS under spinal anaesthesia. All patients received postoperative multimodal analgesic therapy, including ibuprofen and paracetamol. The OXY group got standardized extended release and short acting oral treatment (and in a few cases intravenous OXY) as needed and the other group received current standard of care, IVM as needed for 24 h, followed by codeine. Opioid treatment lasted maximum five days. Outcome measures were pain intensity (numerical rating scale, NRS), opioid requirements, duration of administering opioids and safety for mother and newborn. All opioids in the study were expressed in OXY equivalents, using a conversion table. As the bioavailability of each opioid has a certain extent of interindividual bioavailability this conversion represents an approximation. The possible influence of opioids on the newborns was evaluated by the Neurological Adaptive Capacity Score at birth and at 24 and 48 h.Results During the first 24 h, there were no differences between treatments in opioid requirements or mean pain intensity at rest but pain intensity when asking for rescue medication was lower in the OXY than in the IVM group (mean ± SD; 5.41 ± 6.42 vs. 6.42 ± 1.61; p = 0.027). Provoked pain (uterus palpation) during the first 6h was also less in the OXY group (3.26 ± 2.13 vs. 4.60 ± 2.10; p = 0.007). During the 25–48 h period postoperatively, patients on OXY reported significantly lower pain intensity at rest (2.9 ± 1.9 vs. 3.8 ± 1.8; p = 0.039) and consumed less opioids (OXY equivalents; mg) (31.5 ± 9.6 vs. 38.2 ± 38.2; p = 0.001) than those on IVM/codeine. The total amount of opioids 0–5 days postoperatively was significantly lower in the OXY than in the IVM/codeine group (108.7 ± 37.6 vs. 138.2 ± 45.1; p = 0.002). Duration of administering opioids was significantly shorter in the OXY group. Time to first spontaneous bowel movement was shorter in the OXY group compared with the IVM/codeine group. No serious adverse events were recorded in the mothers but the total number of common opioid adverse effects was higher among women on IVM/codeine than among those receiving OXY (15 vs. 3; p = 0.007). No adverse outcomes in the newborns related to treatment were observed in either group.Conclusions In a multimodal protocol for postoperative analgesia after CS better pain control and lower opioid intake was observed in patients receiving oral OXY as compared to those on IVM/codeine. No safety risks for mother and child were identified with either protocol.ImplicationsOur findings support the view that use of oral OXY is a simple, effective and time saving treatment for postoperative pain after CS.

scholarly journals Effects of Preoperative Parental Pain Management Educational Interventions on the Postoperative Pain Intensity and Duration of Small Children Who Underwent One-Day Surgery: A Prospective Randomized Controlled Trial

2020 ◽  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Educational Interventions ◽  
Control Groups ◽  
Small Children ◽  
Pain Scores ◽  
And Control ◽  
At Home

Objectives: To evaluate effects of parental pain management educational interventions on postoperative pain assessment, intensity and duration of small children after a one-day-pediatric surgery. Methods: We conducted a prospective randomized, observational study of parental and nurse’s pain assessments in children. The Parents’ Postoperative Pain Management rating scale (PPPM), Wong-Baker FACES Pain Rating Scale (W-B) or the Numerical Rating Scale (NRS) was used. The children’s pain was assessed by parents who were or were not (intervention vs. control groups) preoperatively educated about pain management postoperatively in the hospital and the first three days at home. Nurses who cared for the children postoperatively in the hospital, independently from the parents, assessed the children’s postoperative pain with W-B and NRS. Results: One hundred and fifty-two parents and their children were included in the study. Complete data were available for 142 parents and their children, with one parent, usually the mother (108 (76.1 %)), being involved at all stages of the study. No differences in children’s postoperative pain scores and analgesic use at home were found between the two parental groups (intervention and control groups). Parental pain scores after surgery was strongly positively correlated with pain duration, and analgesic use by their children at home. Pain intensity scores assessed by nurses in the hospital were lower compared to parental pain intensity scores. There was high inter-rater reliability between the PPPM, Wong-Baker, and NRS scales. Conclusions: No differences in postoperative pain in children were found between the intervention and control groups of parents. Parents gave higher scores of pain intensity in children than nurses did.

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