The relationship between early postoperative agitation and pain scores in children undergoing lower abdominal surgery

In our study, we aimed to determine the relationship between early postoperative agitation and preoperative anxiety scale mYPAS, pain scales FLACC, Wong Baker, PPPM and delirium scale PAED in children who underwent subumbilicus surgery. 133 patients, ASA I-II, 0-18 age group, who underwent surgery for the first time between July 2021 and January 2023, were included in the study. Patients' age, gender, comorbidities and ASA score, type of surgery, whether the surgery is urgent or elective, premedication applied, time between hospitalization and surgery, anesthesia method applied, whether caudal anesthesia was applied, duration of surgery, date of surgery, intraoperative developments complications were recorded. To evaluate the preoperative anxiety levels of the patients mYPAS was recorded in the preoperative observation unit, then PAED, FLACC, Wong Baker values at the extubation (0th minute), 5th minute, 10th minute and 15th minute, and PPPM values on the 1st day and 2nd day after the surgery was recorded. It was observed that the rate of delirium was higher in boys than in girls. It was observed that PAED values and delirium were higher in emergency cases compared to elective cases, especially in the 10th and 15th minutes postoperatively, and the rate of delirium was higher in cases lasting longer than 60 minutes. It was determined that children with high preoperative anxiety levels according to mYPAS had higher postoperative pain levels according to FLACC scale. However, pain levels were lower in children who underwent caudal block, even if their anxiety was high. At the same time, it was observed that the pain levels of the patients who underwent caudal block were lower on the 1st and 2nd postoperative day according to the PPPM scale. It was found that as alertness increased in patients with caudal block, the delirium score increased more than in those without block. In our study, the usefulness of the commonly used pain and delirium scales was supported, and the PPPM scale, which has not been studied much, was also found to be useful.