title: A comparison of the postoperative pain experience in children with and without attention-deficit hyperactivity disorder (ADHD).
abstract: BACKGROUND
  Children with attention-deficit hyperactivity disorder (ADHD) may experience pain differently compared to other children, yet the evidence is equivocal regarding whether pain is heightened or dampened. This prospective observational study, therefore, was designed to compare the postoperative pain experiences in children with and without ADHD.
  
  
  METHODS
  Children aged 7-17 years with a diagnosis of ADHD (n = 119) who were scheduled for a surgical procedure requiring postoperative pain management and a matched cohort of children without ADHD were recruited (n = 122). Postoperative pain scores and analgesic use were recorded for 1 week, as was parents' estimate of their child's return to normal activity.
  
  
  RESULTS
  There were no differences in highest pain scores between children with ADHD (3.3 ± 2.5, 0-10 numerical rating scale) and those without (2.8 ± 1.9). Postoperative opioid use was also similar on day 1 following surgery (0.12 ± 0.3 mg·kg(-1) vs 0.08 mg·kg(-1 ) ± 0.1 morphine equivalents, respectively). Children with ADHD, however, had a significantly longer return to normal activity (4.9 ± 3.8 vs 3.8 ± 3.0 days; P < 0.05).
  
  
  CONCLUSIONS
  Results suggest that there were no differences in the postoperative pain experiences of children with and without ADHD. However, the observation that children with ADHD took longer to return to baseline activity will be important in educating parents regarding their child's postoperative experience.
authors.affiliation: Division of Pediatric Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Sondra
authors.initials: S
authors.lastname: Rosander
authors.affiliation: Division of Pediatric Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nause-Osthoff
authors.affiliation: Division of Pediatric Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Terri
authors.initials: T
authors.lastname: Voepel-Lewis
authors.affiliation: Division of Pediatric Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA.|Center for Behavioral and Decision Sciences in Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Tait
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D010149:Postoperative Pain / Q000453:epidemiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: attention-deficit hyperactivity disorder; child; postoperative pain