https://doi.org/10.4081/pmc.2023.288
Correlation between FLACC scale score and analgesic requirement in children undergoing minimally invasive surgery
Submitted: 7 August 2022
Accepted: 17 April 2023
Published: 22 May 2023
Accepted: 17 April 2023
Abstract Views: 1200
PDF: 509
HTML: 9
HTML: 9
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Postoperative pain presents several challenges in pediatric minimally invasive surgery (MIS). The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale is a valid scale for pediatric postoperative pain. The aim of our study was to assess postoperative pain using FLACC scale and to analyze the correlation between FLACC scale score and analgesic requirement in children underwent MIS. We retrospectively analyzed data of 153 children aged 2 months-3 years who underwent MIS in our unit from January 2019 and December 2019. Postoperative pain assessment was established using FLACC scale. In each patient were analyzed the correlation between FLACC score and analgesic requirement. Pain evaluation was assigned immediately after surgery and at 15 and 60 minutes. 36.6% of patients (56 children) were asleep so considered pain free; 21.6% of patients (33 children) had a FLACC score more than 7 so they required analgesics and the pain assessment 15 and 60 minutes after was significantly lower. 41.8% of patients (64 children) had a postoperative FLACC score less than 3, so they didn’t require any analgesic treatment. On the basis of our results, we recommend FLACC scale for postoperative pain assessment in children underwent MIS aged 2 months-3 years. FLACC scale is an effective and precise scale in detection of postoperative analgesic requirement in children and it could be extended in different age groups with further research.
Babl FE, Crellin D, Cheng J. The use of the faces, legs, activity, cry and consolability scale to assess procedural pain and distress in young children. Pediatr Emerg Care 2012;28:1281–96.
DOI: https://doi.org/10.1097/PEC.0b013e3182767d66
Chan JY, von Baeyer CL. Cognitive developmental influences on the ability of preschool-aged children to self-report their pain intensity. Pain 2016;157:997–1001.
DOI: https://doi.org/10.1097/j.pain.0000000000000476
Esposito C, Escolino M, Cortese G, et al. Twenty year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs. Surg Endosc 2017;31:1461-8.
DOI: https://doi.org/10.1007/s00464-016-5139-8
Esposito C, Escolino M, Corcione F, et al. Twenty year experience with laparoscopic and retroperitoneoscopic nephrectomy in children: considerations and details of technique. Surg Endosc 2016;30:2114-8.
DOI: https://doi.org/10.1007/s00464-015-4472-7
Esposito C, Masieri L, Castagnetti M, et al. Robot assisted vs laparoscopic pyeloplasty in children with ureteropelvic junction obstruction (UPJO): technical considerations and results. J Pediatr Urol 2019;15:667.e1-667.e8.
DOI: https://doi.org/10.1016/j.jpurol.2019.09.018
Esposito C, Escolino M, Lopez M, et al. Surgical Management of Pediatric Vesicoureteral Reflux: A Comparative Study Between Endoscopic, Laparoscopic, and Open Surgery. J Laparoendosc Adv Surg Tech A 2006;26:574-80.
DOI: https://doi.org/10.1089/lap.2016.0055
Johnston CC, Stevens B, Craig KD, Grunau RV. Developmental changes in pain expression in premature, full-term, two- and four- month-old infants. Pain 1993;52:201–8.
DOI: https://doi.org/10.1016/0304-3959(93)90132-9
Johansson M, Kokinsky E. The comfort behavioural scale and the modified FLACC scale in paediatric intensive care. Nurs Crit Care 2009;14:122–30.
DOI: https://doi.org/10.1111/j.1478-5153.2009.00323.x
Gilbert CA, Lilley CM, Craig KD, et al. Postoperative pain expression in preschool children: validation of the child facial coding system. Clin J Pain 1999;15:192–200.
DOI: https://doi.org/10.1097/00002508-199909000-00006
Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 1997;23:293-7.
Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the Face, Legs, Activity, Cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain 2015;156:2132-51.
DOI: https://doi.org/10.1097/j.pain.0000000000000305
Willis MH, Merkel SI, Voepel-Lewis T, Malviya S. FLACC behavioral pain assessment scale: a comparison with the child’s self-report. Pediatr Nurs 2003;29:195-8.
Gomez RJ, Barrowman N, Elia S, et al. Establishing intra- and inter-rater agreement of the face, legs, activity, cry, consolability scale for evaluating pain in toddlers during immunization. Pain Res Manag 2013;18:124–8.
DOI: https://doi.org/10.1155/2013/897104
Stalnikowicz R, Mahamid R, Kaspi S. Undertreatment of acute pain in the emergency department: a challenge. Int J Qual Health Care 2005;17:173–6.
DOI: https://doi.org/10.1093/intqhc/mzi022
Fournier-Charriere E, Tourniaire B , Carbajal R, et al. EVENDOL, a new behavioral pain scale for children ages 0 to 7 years in the emergency department: design and validation. Pain 2012;153:1573–82.
DOI: https://doi.org/10.1016/j.pain.2012.02.024
Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care 2010;19:55–61.
DOI: https://doi.org/10.4037/ajcc2010624
How to Cite
Turco, A., Cerulo, M., Del Conte, F., Coppola, V., Severino, G., Escolino, M., & Esposito, C. (2023). Correlation between FLACC scale score and analgesic requirement in children undergoing minimally invasive surgery. La Pediatria Medica E Chirurgica, 45(1). https://doi.org/10.4081/pmc.2023.288
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Cosimo Bleve, Valeria Bucci, Maria Luisa Conighi, Francesco Battaglino, Lorenzo Costa, Lorella Fasoli, Elisa Zolpi, Salvatore Fabio Chiarenza, Horseshoe kidney and uretero-pelvic-junction obstruction in a pediatric patient. Laparoscopic vascular hitch: A valid alternative to dismembered pyeloplasty? , La Pediatria Medica e Chirurgica: Vol. 39 No. 4 (2017)
- Salvatore Fabio Chiarenza, Lorenzo Costa, Maria Luisa Conighi, Elisa Zolpi, Lorella Fasoli, Giulia Brooks, Enrico La Pergola, Cosimo Bleve, GERD surgery in non-neurologic patients: Modified Laparoscopic Hill-Snow Repair is a valid alternative to Nissen fundoplication. Results of a 20 years of follow-up , La Pediatria Medica e Chirurgica: Vol. 45 No. 1 (2023)
- Francesca Scarano, Alessandra Dalla Corte, Roberto Michielon, Alessandro Gava, Paola Midrio, Application of a non-pharmacological technique in addition to the pharmacological protocol for the management of children’s preoperative anxiety: A 10 years’ experience , La Pediatria Medica e Chirurgica: Vol. 43 No. 1 (2021)
- Maria Enrica Miscia, Maria Castellano, Stella Chiarini, Giuseppe Lauriti, Marco Casaccia, Pierluigi Lelli Chiesa, Gabriele Lisi, Pediatric primary spontaneous pneumothorax: a comparison of treatment at pediatric surgery vs. thoracic surgery departments , La Pediatria Medica e Chirurgica: Vol. 45 No. 1 (2023)
- Edoardo Bindi, Fabiano Nino, Francesco Pierangeli, Michele Ilari, Taisia Bollettini, Elisa Chiarella, Francesca Mariscoli, Gianluca Gentilucci, Alba Cruccetti, Giovanni Cobellis, Transumbilical laparoscopic-assisted appendectomy versus laparoscopic appendectomy in children: a single center experience , La Pediatria Medica e Chirurgica: Vol. 45 No. 1 (2023)
- Mirko Bertozzi, Laura Marchesini, Simonetta Tesoro, Antonino Appignani, Laparoscopic herniorrhaphy in children , La Pediatria Medica e Chirurgica: Vol. 37 No. 2 (2015)
- Salvatore Fabio Chiarenza, Cosimo Bleve, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Pietro Bagolan, Claudio Vella, Maria Luisa Conighi, Daniela Codric, Simona Nappo, Paolo Caione, Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of pediatric nephrectomy and partial nephrectomy , La Pediatria Medica e Chirurgica: Vol. 39 No. 3 (2017)
- Salvatore Fabio Chiarenza, Cosimo Bleve, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Pietro Bagolan, Claudio Vella, Maria Luisa Conighi, Daniela Codric, Simona Nappo, Paolo Caione, Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the ureteropelvic-junction obstruction , La Pediatria Medica e Chirurgica: Vol. 39 No. 3 (2017)
- Sarah Abdelmohsen, Mohamed Abdelkader Osman, Hussein Ali Mostafa, Mohamed Fathy, Ibrahim Ali Ibrahim, Mahmoud Mohamed Mostafa, Almoutaz A. Eltayeb, Osama Abdullah Abdul Raheem, Rectovestibular fistula: Which surgical approach is suitable? A randomized controlled trial , La Pediatria Medica e Chirurgica: Vol. 44 No. 1 (2022)
- Ayu Widya Lestari, Chia-Kuei Lee, Happy Hayati, The impact of parental psychological distress on child behavior issues in hospitalized children , La Pediatria Medica e Chirurgica: Vol. 45 No. 1 (2023)
You may also start an advanced similarity search for this article.