The Overview Of Postoperative Pain In Children And The Research Progress On Postoperative Analgesia For Pectus Excavatum In Pediatric Patients After Nuss Procedure

The American Academy of Pediatrics and the American Pain Association has defined pain as an uncomfortable subjective feeling that is a comprehensive response to feelings,emotions,cognition,and behavior[1].Because of the lack of language skills in children,the International Society for Pain Research has added an explanation that no communication capacity can not deny an individual's pain experience and the need for proper control of pain in 2001[2,3].Pain is not only a symptom of the disease,but becomes a valuable symptomatic perception[4].Pain assessment and postoperative analgesia in children has been a complex and difficult problem,and pain can cause childhood behavior and perception changes in future,although the study of pediatric analgesia is becoming more and more,but the hospitalized children are still suffering from unacceptable pain[5].How to accurately assess the degree of pain in children and provide appropriate analgesia is still probles need further research.Pectus excavatum(PE)is the most common congenital chest wall deformity and the Nuss procedure is the conventional surgical treatment for this disease.Although the Nuss procedure is minimally invasive,it is still burdened with severe postoperative pain,and the Pain is undoubtedly a dominant factor that determines the quality of the postoperative course of patients with pectus bar placement.Optimal pain management in the early postoperative stages can expedite the return to normal function and increase patient satisfaction.Thus the pain management after the Nuss procedure is meaningful and challenging.The common pain management strategies have included intravenous analgesia,thoracic epidural,intercostal block,thoracic paravertebral block and multimodal anesthesia.Besides the perioperative hypnosis and the anxiety management will be helpful for the release of the pain for patients undergoing the Nuss procedure.The pain management strategies above all have advantage and disadvantage and the analgesic technique based on patient preference and institutional resources is deserved more study.