ORIGINAL ARTICLE Structured intervention for management of pain following day surgery in children Søren Walther-Larsen 1 , Gitte Bruun Aagaard 1 , Susanne Molin Friis 1 , Trine Petersen 1 , Jørn Møller-Sonnergaard 2 & Janne Rømsing 3 1 Pediatric Pain Service, Department of Anesthesiology, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark 2 Department of Pharmaceutics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 3 Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark What is already known • We are faced with an increased flow of pediatric patients undergoing day surgery. What this article adds • Following structured intervention pain was well managed in children after ambulatory surgery. Keywords children; day surgery; postoperative pain; pain assessment; analgesics; parents; information Correspondence Søren Walther-Larsen, M.D., Department of Anaesthesia, The Juliane Marie Centre, Rigshospitalet, 9-Blegdamsvej, DK-2100 Copenhagen Ø, Denmark Email: Soeren.Walther-Larsen@regionh.dk Section Editor: Per-Arne Lonnqvist Accepted 30 September 2015 doi:10.1111/pan.12811 Summary Background: Ambulatory surgery forms a large part of pediatric surgical prac- tice. Several studies indicate that postoperative pain is poorly managed with more than 30% of children having moderate to severe pain. In a busy outpa- tient clinic contact between healthcare professionals and the family is increas- ingly limited calling for a global and efficient pain management regime. Objective: The aim of this prospective observational cohort study was to determine postoperative pain intensity following day surgery in children after our structured intervention for pain management. Methods: A number of interventions in an effort to address barriers to effective postoperative pain management after day surgery were identified in the litera- ture. By introducing our concept structured intervention, we aimed to address the majority if not all these barriers. Accordingly, we adapted postoperative pain management to each child using a multimodal approach consisting of sur- gery-specific analgesia with weight appropriate doses of acetaminophen and ibuprofen. Analgesics were handed out to the parents in formulations accepted by child and parent and after thorough information to the parents. Results: Two hundred and forty-five children were scheduled for surgery dur- ing the 3-month period of which 149 children were available for analysis. The postoperative pain as assessed by the parents with a the Short Form of the Parents’ Postoperative Pain Measure (PPPM-SF) was well managed exhibit- ing a median pain score of 4 on postoperative day 0 (POD0) and median 1 on postoperative day 1 (POD1) and a numeric rating scale (NRS) median pain score of 2 on POD0 and median 1 on POD1. We found a highly significant correlation between the PPPM-SF and the NRS scores. Conclusion: After thorough information of the parents we have successfully implemented a surgery-specific regime of primarily around-the-clock dosing of drug formulations acceptable for the specific child with dispensed medica- tion ready available for the family. © 2015 John Wiley & Sons Ltd Pediatric Anesthesia 26 (2016) 151–157 151 Pediatric Anesthesia ISSN 1155-5645