Pain management in children with and without cognitive impairment following spine fusion surgery

Paediatr Anaesth. 2001 Jul;11(4):453-8. doi: 10.1046/j.1460-9592.2001.00686.x.


Background: We compared pain assessment and management practices in children with and without cognitive impairment (CI) undergoing spine fusion surgery.

Methods: The medical records of 42 children (19 with CI and 23 without) were reviewed and data related to demographics, surgery, pain assessment and management, and side-effects were recorded.

Results: Fewer children with CI were assessed for pain on postoperative days (POD) 0-4 compared to those without CI (P < 0.002). Self-report was used for 81% of pain assessments in children without CI, while a behavioural tool was used for 75% of assessments in cognitively impaired children. Children with CI received smaller total opioid doses on POD 1-3 compared to those without CI (P < or = 0.02). Furthermore, children without CI received patient/nurse-controlled analgesia for more postoperative days than children with CI (P=0.02).

Conclusion: Our data demonstrate a discrepancy in pain management practices in children with and without CI following spine fusion.

MeSH terms

  • Analgesia, Patient-Controlled
  • Analgesics, Opioid / therapeutic use*
  • Child
  • Cognition Disorders*
  • Communication
  • Female
  • Humans
  • Intellectual Disability*
  • Male
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Postoperative Complications
  • Postoperative Nausea and Vomiting
  • Spinal Fusion*


  • Analgesics, Opioid