ABSTRACT
Background: The impact of pain experienced after surgery hinders the recovery process. Limited research exists regarding the approach to managing postoperative pain in children in developing nations.
Aim: Our objective was to assess the present methods employed by pediatric surgeons in Pakistan for managing postoperative pain in children. 
Methods: A group of 48 pediatric surgeons/trainees participated in two yearly conferences of the Association of Pediatric Surgeons of Pakistan, held in May 2023 and April 2024. These individuals were surveyed using a questionnaire to gather information about the methods used for managing postoperative pain in children, as well as their personal opinions and perspectives.
Results: Forty people filled out the survey, which means that 85% of the people asked responded. Out of those who responded, 29 of them (77%) were consultants, and 11 of them (23%) were trainees. Only 3 of the respondents (6%) used any guidelines, and 10 of them (27%) had a set way to handle pain in children after surgery at their hospital. Almost half of the respondents (17, which is 45%) relied on their clinical judgment to assess postoperative pain. Some other ways they assessed pain included crying, needing oxygen to keep their blood oxygen levels above 96%, increased vital signs (like heart rate and blood pressure), facial expressions, and trouble sleeping (12 people, which is 34.3%). Other methods included observing how alert the child was, how calm they were, how they responded to breathing or crying, physical movement, muscle tension, and facial expressions (13 people, which is 37%). There was also a verbal rating scale (11 people, which is 28%). In newborn babies, 90% of the respondents used paracetamol and 34% used pentazocine for routine pain relief after surgery. None of the respondents used morphine for newborns after surgery. In older children, the most commonly used pain relievers were paracetamol (36 people, which is 93%), pentazocine (31 people, which is 82%), and nonsteroidal anti-inflammatory drugs (29 people, which is 81%). More than half of the respondents (21 people, which is 57%) were not happy with how they currently manage pain after surgery.
Conclusion: Doctors did not often check how much pain people were feeling, and the treatment they gave for pain, even though it used different methods, did not follow a specific plan. This means that people didn’t always get enough relief from their pain. We need to do a better job of recognizing and taking care of the pain people feel after surgery in our hospitals. We should try harder to evaluate and treat their pain.
Keywords: Pediatric Surgery, Postoperative Pain, children, pediatric surgeons, Developing Nations.