Postoperative Pain and Analgesic Use in Children Receiving Dental General Anesthesia

Abstract

Background: Postoperative pain is the most common morbidity following pediatric dental treatment under general anesthesia (GA), yet caregiver administration of analgesic medications and its relationship to pain outcomes remains poorly characterized. Purpose: To describe postoperative pain intensity and analgesic use following dental treatment under GA, and to evaluate how caregiver adherence to analgesic instructions and treatment-related factors are associated with child pain outcomes. Methods: In this prospective cohort study, 100 healthy children (<18 years; ASA I–II) undergoing outpatient dental GA were enrolled. After surgery, caregivers were instructed to alternate acetaminophen and ibuprofen, and pain and medication use were assessed on the day of surgery and postoperative days one to three. Results: On the day of surgery, 54% of children experienced mild-to-moderate pain and 17% had severe pain. Pain decreased rapidly, with most children reporting minimal/no pain by day two (76%) and day three (94%). During days 0–1, only 30% of caregivers adhered to the alternating analgesic regimen, and 17% administered medications on a fixed schedule. Adherence was higher when more teeth were treated, multiple extractions were performed, and sutures were placed (P ≤ .05). Children with higher pain scores were more likely to receive pain medication. Conclusions: Postoperative pain after comprehensive dental rehabilitation under GA was typically short-lived, with most children improving by postoperative day two. Severe pain was common on the day of surgery but rarely persistent. Medication adherence was low, with caregivers favoring reactive pain management over scheduled dosing.