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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2005 March;29(1):11-6
Acute postoperative pain management in paediatric patients undergoing foot surgery
Napoli V., Napoli E., De Siena L.
In children aged from 3 months to 16 years, various foot pathologies require surgical treatment. The pain response to surgical stimulation, present in and peculiar to every age group, is influenced by many factors which have to be recognised and if possible treated. Pain is best managed by way of a multimodular, polyphasic therapeutic programme which associates appropriate psychological, behavioural and environmental support with the administration of effective drugs. The selection, dosage and moment of administration of analgesics should be related to the type of operation and to the age of the patient in relation to the degree of maturity of his noble organs. The use of more than one drug acting synergetically is to be preferred because it improves the therapeutic response and there is a consequent reduction in respective doses. Their preventive and time-guided administration reduces the perception of pain stimuli and contributes to the sedation of the patient and to his or her serene acceptance of events. In our foot surgery practice we use centrally-acting Tramadol and peripherally acting paracetamol/codeine, the association of which responds fully to therapeutic needs with a limited biological impact. The non-painful rectal and oral administration routes are those most acceptable to the patient.