Trends in intraoperative pain relief in anesthesized Nigerian pediatric patients: Implications for a developing economy

Background : New drugs and new modalities for intraoperative pain relief is the current trend in pain management.
Aim: The study aims at examining the current trend in intraoperative pain relief in patients of pediatric age at the University of Benin Teaching Hospital (UBTH) and its implications for a developing economy such as Nigeria.
Materials and Method: A retrospective study of 652 patients of pediatric age undergoing various surgical procedures was carried out in UBTH, Nigeria from January 2006 to June 2008. The intraoperative pain relief methods were documented including demographic data, anesthetic technique, associated morbidities and outcome.
Results: Old generation opioid drugs and old modalities of pain relief including intravenous routes (573 i.e. 87.9%) and caudal blocks (46 i.e. 7.1%) were used in the intraoperative period in pediatric patients studied in UBTH. Adverse events of respiratory depression and hypotension including tachycardia and hypertension from ineffective analgesia were found in 14 patients (2.1%). The anesthetic technique was mainly general anesthesia for surgical procedures which were mainly laparotomies and urogenital surgeries.
Conclusion: The study revealed a lagging behind trend in intra-operative pain relief for pediatric surgical patients in UBTH. This has enormous implications of increased costs of drugs, equipment, facilities and the training and skills acquisition of physicians and other relevant health care personnel in the development ofpediatric acute pain service (PAPS) whose current trend worldwide is information technology based. This current trend also includes the increased use of regional blocks including nerve blocks. These avoid the side effects of conventional parenteral opioids and leads to improved patient safety and outcome.