Good Practice in Postoperative and Procedural Pain Management ...

Postoperative painl NCCPC-PV (Non-Communicating Children’s PainChecklist – Postoperative Version) (100): intended for3–19 year olds.l PPP (The Pediatric Pain Profile) (101): intended for1–18 year olds.• Revised FLACC (50): intended for 4–19 year olds.Parent report of their child’s postoperative painintensityThe most psychometrically sound and feasible parentreport tool, based on age/developmental level and typeof pain, has been recommended for use in clinical trials(13). However, this may not necessarily directly transferto clinical utility and more research is needed.• PPPM (Parents Postoperative Pain Measure) (95);see also (96,97).3.2.3 Physiological measuresPhysiological parameters such as heart rate variability,skin conductance, and changes in salivary cortisol canbe used indirectly to indicate the presence of pain (103–106). However, blood pressure, heart rate, and respiratoryrate have been shown to be unreliable indicators innewborns, infants, and young children with wide interindividualbehavior–physiology correlations after majorsurgery in 0–3-year-old infants (16). More recently, themagnitude of evoked cortical activity has been suggestedas a possible indicator of pain (107). While the methodappears promising and correlations with other painmeasures have been found to be good, similarly to themeasurement of other physiological parameters such ascortisol changes, it has limited clinical utility. It is questionablewhether the pain experience can be meaningfullyreduced to physiological activation alone;therefore, physiological measures should be used in conjunctionwith other tools/measures to determine thepresence and intensity of pain.References1 Finley GA, Franck L, Grunau R et al. WhyChildren’s Pain Matters. Seattle, WA: IASP,2005.2 Howard R. Current status of pain managementin children. 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