Children of five or more years old can operate visual or colour analogue scales for expression of pain. Older Children . Like adults, children more than seven years old can express intensity, location and quality of pain. Any scoring system such as horizontal VAS, vertical colour analogue scale and self reporting are effective and reliable. Management of Postoperative Pain Operative procedures associated with severe postoperative pain should not be performed as day surgery.
Oral analgesics are the mainstay of pain relief at home.
Topical Anaesthesia . EMLA cream is an eutectic mixture of prilocaine and lignocaine and is very effective at providing dermal anaesthesia. Topical EMLA decreases the pain associated with circumcision, release of preputial adhesion, myringotomies and skin grafting. To obtain effective analgesia cream should be applied to the skin with an occlusive dressing about 45 to 60 minutes prior to surgery. EMLA should be used with caution in infants less than 3 months of age or in patients who are taking sulphonamides or other methaemoglobin inducing medications because of potential of methaemoglobinaemia.