Evaluation of perioperative pain management in pediatric ENT surgery: multicenter study carried out in 80 children aged 0 to 10 years in Yaoundé.

Abstract

Introduction: Postoperative pain is common in paediatric ENT surgery. In resource-limited settings, assessment and therapeutic adequacy remain insufficiently documented. This study aimed to evaluate the management of postoperative pain in children aged 0 to 10 years undergoing ENT and head and neck surgery.

Methods: This was a cross-sectional and analytic study with prospective data collection conducted from February to July 2025 in five university hospitals in Yaoundé. Children who underwent surgery under general anaesthesia were included by consecutive sampling. Pain was assessed at H0, H6, H12, H24 and H36 using the EVA/EN (≥7 years) and EVENDOL (<7 years) scales. Compliance with pain management was analysed according to WHO international recommendations based on pain intensity.

Results: Eighty children were analysed (mean age: 3.35 years; sex ratio: 1.5). Adenotonsillectomy accounted for 47.5% of procedures. Multimodal analgesia was used in 71.3% of patients, mainly through a combination of level I measures. At H0, 76% of children ≥7 years of age had severe pain and 89.8% of those <7 years of age had an EVENDOL score >4/15. Overall treatment compliance was low at H0 (23.75%), improved at H12–H24 (>90%), then decreased at H36 (42.5%). Systematic assessment by staff was only performed in 24% of cases.

Conclusion: Despite the frequent use of multimodal analgesia, management remains insufficiently adapted to the intensity of pain, particularly in the immediate postoperative phase. Strengthening standardised protocols and systematic assessment is essential.