• Mihaela Visoiu, Jacques Chelly, and Tanya Kenkre.
• Department of Pediatric Anesthesiology, Acute Pediatric Pain Service, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
• Pain Rep. 2019 Jul 1; 4 (4): e763.

IntroductionThe prevalence of moderate to severe pain is high in hospitalized teenage patients admitted to surgical services.ObjectivesThe aims of this study were to determine (1) the preoperative and postoperative factors influencing teenager postoperative pain perception; and (2) suffering, defined as the patient's anxiety, pain catastrophizing thoughts, and mood.MethodsData were collected from medical records and from 2 medical interviews at the time of enrollment and postoperative day 1. Stepwise linear regression was conducted to assess variables that predicted teenagers' pain scores and suffering.ResultsTwo hundred two patients (mean age = 13.8 years, SD = 1.9), 56.4% females, scheduled for laparoscopic surgical procedures completed the study. The variables found to be significant predictors of pain response in teenagers were pain on the day of surgery (6.81, 95% confidence interval [CI] = 0.08-13.55, P = 0.05) and use of regional anesthesia (single-injection rectus sheath, transversus abdominis plane, and paravertebral nerve blocks) (-6.58, 95% CI = -12.87 to -0.30, P = 0.04). The use of regional anesthesia was found to predict mood responses (all patients: 2.60, 95% CI = 0.68-4.52, P = 0.01; girls: 3.45, 95% CI = 0.96-5.93, P = 0.01; 14-17-year-old teens: 2.77, 95% CI = 0.44-5.10, P = 0.02) and to negatively predict catastrophic thoughts among all patients as a group (-4.35, 95% CI = -7.51 to -1.19, P = 0.01) and among 14- to 17-year-old teens (-5.17, 95% CI = -9.44 to -0.90, P = 0.02).ConclusionA comprehensive pain approach that includes truncal blocks may improve teenagers' postoperative pain control after laparoscopic surgeries.Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

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