Prevalence and characteristics of headache in Dutch schoolchildren.

The aim of this study was to determine whether there has been an increase in headache prevalence in Dutch children and to compare headache characteristics of children with low, medium and high headache severity.A sample of 2358 schoolchildren between the ages of 10 and 17 years filled out Waters' Headache Questionnaire and the Paediatric Pain Assessment Tool. Results showed that 21% of the boys and 26% of the girls at elementary school, and 14% of the boys and 28% of the girls at high school reported weekly headaches. When compared to figures from a previous study in the Netherlands published in 1985, the prevalence of weekly headaches in 10-17-year-olds has increased by 6%. In boys at elementary school, the prevalence of headaches with a frequency of a few times a week has doubled. Children with low, medium and high headache severity differed with respect to all headache characteristics, i.e. pain quality, accompanying symptoms, warning signals, location, onset, impact of headache, family occurrence, perceived cause, medical consultation, and school absence.

Patient controlled analgesia in children and adolescents: a randomized controlled trial.

In children, patient controlled analgesia (PCA) and continuous infusion (CI) of morphine are well established methods of relieving postoperative pain. This study was designed to assess the efficacy of PCA plus background infusion (BI) (15 microg x kg(-1) x h(-1) and bolus doses of 15 microg x kg(-1) with a lock-out interval of 10 min) with CI (20 to 40 microg x kg(-1) x h(-1)) in terms of analgesia, morphine needs and side-effects. A stratified randomized controlled trial was carried out. 47 children aged 5-18 years undergoing major elective lower/upper abdominal or spinal surgery were allocated. The magnitude of surgery was assessed by the Severity of Surgical Stress scoring (SSS) system. Pain was assessed by self-report every three h. Side-effects compatible with morphine as well as morphine consumption were recorded. Morphine consumption was significantly increased in the PCA group compared with the CI group. Moreover, morphine consumption was associated with SSS, independent of the technique of administration. There were no significant differences between groups in pain scores or in the incidence of side-effects.