Evaluation of pain perception in patients of 0-5 months of age with cleft lip and palate subjected to pre-surgical orthopedics

Resumen

Introduction: While it is considered that newborns are not able to verbalize feelings and express pain during pre-surgical orthopedic treatment, it is necessary to identify a primary measure of pain in pediatric patients with cleft lip and palate. Objective: The objective of the study was to assess pain during pre-surgical orthopaedic treatment using the FLACC scale, which assesses the expression of the face, legs, activity, scream and compression, and to determine the reliability of this scale in these patients. Material and methods: Six independent observers assessed pain through video recordings of 20 children aged 0 to 5 months during three stages or moments of time: 1. During feeding technique; 2. While taking impressions of the alveolar ridges; 3. During the placement of the pre-surgical orthopaedic appliance. This scale was scored at each stage during the procedure. During the evaluation of the impression taking and placement of the appliance the values were compared with the feeding technique using the paired Wilcoxon test. Intraclass correlation coeffi cients were also used to assess the reliability of the scale. Results: Statistically signifi cant increases in scale scores were found during impression taking (p < 0.000) and appliance placement (p < 0.000) compared to the feeding technique. The reliability of the scale was rated as good (0.71-0.90). Conclusions: Pain was evident according to the FLACC scale during impression of the alveolar ridges and placement of the appliance prior to the patient’s cheiloplasty. In addition, the scale showed good reliability, which provides preliminary support for considering alternative or pharmacological procedures to complement the patient’s treatment