Swarnalakshmi Raghavan
Introduction
Orchidopexy is a common paediatric day-case procedure associated with predictable post-operative pain. Effective pain assessment and management are essential to minimise distress and enable timely discharge. This audit aimed to evaluate whether post-operative pain in children undergoing orchidopexy was appropriately assessed, managed, and reassessed, and to identify opportunities for improvement.
Methods
This retrospective audit included children under 18 years undergoing elective orchidopexy, with a total of 42 patients analysed. Data were collected from anaesthetic charts, drug charts, recovery records, and ward notes. The audit focused on pain score documentation, identification of elevated pain, the clinical response to elevated pain and reassessment following intervention and prior to discharge.
Results
Pain scores were documented within 30 minutes of ward arrival and prior to discharge in 100% of patients. 14% percent of patients had elevated pain scores, all of whom received appropriate rescue analgesia and 75% were reassessed within 60 minutes.
Conclusion
Post-operative pain assessment and management were performed consistently to a high standard in line with national guidance. Care could be further optimised by prioritising nerve blocks in bilateral or older/heavier children, ensuring pre-operative paracetamol and ibuprofen for baseline analgesia, and reinforcing reassessment documentation through continued staff education. Re-audit will help sustain compliance and identify future opportunities for improvement. Standardised and proactive pain management effectively reduces post-operative distress, with targeted interventions required for high-risk patients to eliminate the residual ‘pain gap’.
Authors
Swarnalakshmi Raghavan, Walsall Healthcare NHS trust, Walsall, United Kingdom & Royal Wolverhampton NHS trust, Wolverhampton, United Kingdom
Shubhi Ratra, Royal Wolverhampton NHS trust, Wolverhampton, United Kingdom
Miranda Roberts, Royal Wolverhampton NHS trust, Wolverhampton, United Kingdom