**5. Prevention of postoperative pain in pediatrics**

Although pediatric postoperative pain is often unavoidable, there are measures that can be taken to minimize its intensity and duration. Some strategies to prevent postoperative pain in pediatrics include:


One of the methods most used by anesthesiologists is anesthetic adjuvants, which are drugs that are used in combination with local or general anesthetics to improve the efficacy of anesthesia and reduce postoperative pain [11]. In pediatrics, various anesthetic adjuvants are used to prevent postoperative pain, including:


Dexmedetomidine dose (mcg/kg/h) = body weight (kg) × starting dose (mcg/ kg/h) × adjustment factor.

The adjustment factor varies according to the age of the child: < 6 months: adjustment factor of 0.4.

6 months - 5 years: adjustment factor of 0.5.

• Magnesium: Magnesium has been shown to have pain-relieving properties and reduces the need for opioid pain relievers in children after surgery. In general, for the administration of IV magnesium in pediatrics, the recommended dose is 25 to 50 mg/kg, diluted in 5% saline or dextrose solution, at an infusion rate not greater than 150 mg/minute.

• Lidocaine: In addition to its use as a local anesthetic, lidocaine has been used as an anesthetic adjuvant to reduce postoperative pain in children. In regional epidural anesthesia, the dose of lidocaine is generally calculated based on the weight of the child, with a typical dose of 1–2 mg/kg. In local anesthesia, the maximum recommended dose is 4.5 mg/kg, and it can be reduced depending on the weight and age of the child.

Anesthetic adjuvants may offer several benefits in children, including:


It is important to keep in mind that each child is different, and that the benefits of anesthetic adjuvants may vary depending on the case.

Another of the most widely used and recommended methods for postoperative pain management are non-pharmacological techniques, for example, stress and anxiety reduction. Strategies to reduce anxiety and stress in children before surgery can help prevent postoperative pain in several ways. First, by reducing anxiety and stress, the sensation of pain and the perception of its intensity can be reduced. Additionally, these techniques can help reduce the need for pain relievers and other postoperative pain medications, which can decrease the risk of side effects and complications. In addition, some techniques, such as muscle relaxation and meditation, can help improve sleep quality and reduce postoperative insomnia [12].

Some strategies that can help reduce anxiety and stress in these children include:


*Postoperative Pain in Pediatrics DOI: http://dx.doi.org/10.5772/intechopen.111788*


It is important that any strategy to reduce anxiety and stress in children who will undergo surgery is discussed with the medical team and that the most appropriate option is chosen for each child.
