الفهرس 
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Abstract
The International Association for Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. It is to be noted that pain is not just a physical sensation. It is also an emotional experience. It varies from person to person and in the same person from time to time. There may be a strong emotional component contributing to the pain experience; but that does not mean. That the suffering is less important. A simple no-nonsense definition of pain is “Pain is what the patient says, hurts, the emphasis is on the patient’s experience
Postoperative pain is defined as an acute or chronic pain that is experienced after an operation or surgical procedure. While significant studies have been made in medicine in this regard, postoperative pain management can be quite difficult, especially in situations where the body sustained some physical trauma due to the operation itself. After extremely invasive procedures, it is to d safe to say that nearly all patients experience some degree of postoperative pain - however, the severity will detect what kind of treatment the medical staff will provide while the patient is hospitalized. If postoperative pain persists upon release from the hospital, pain medications and physical therapy treatments may have to continue for some time on an outpatient basis (Gray P.2008).
The goal in postoperative pain management is to mobilize the person as early as possible, get them eating and drinking as early as appropriate and ensure they are able to cough and deep breathe. Therefore, if patients are not given good postoperative pain management they have an increased risk of chest infections, hypoxia and cardiac problems, pressure sores, deep vein thrombosis, depression, anxiety, anorexia, increased wound infection rates,
Good postoperative pain relief has emerged through our understanding of how different drugs, when used in combination, have a synergistic effect which improves analgesia while reducing specifically opioids side effects of the drugs used. The concept of multimodal analgesia was introduced more than a decade ago and allows for a reduction in the doses of individual drugs when they are combined and hence the incidence of side effects is lowered. It has been shown that the benefits of multimodal analgesia techniques may provide for shorter hospitalization time, improved recovery and function (deep breathing, mobilization, etc) and possibly decreased healthcare costs. (Lake, et al, 2008).
Multimodal analgesia works because of the use of combinations of different analgesics that act by different mechanisms and at different sites in the nervous system, resulting in additive or synergistic analgesia with lowered adverse effects of sole administration of individual analgesics. (Lake, et al, 2008).
Understanding of the anatomic and physiological differences between adults and infants are crucial in order to safely, and in a technically proficient fashion administer spinal anesthesia in children.
The ability of the somatosensory system to detect noxious and potentially tissue-damaging stimuli is an important protective mechanism that involves multiple interacting peripheral and central mechanisms.
Frequent and routine pain assessment and documentation are essential for effective pain management. While self-report of pain using a 0-10 scale represents the gold standard of pain assessment in adults and older cognitively intact children, young children and those who are cognitively impaired frequently lack the cognitive and verbal skills necessary to use such scales.
There are several methods for management of postoperative pain in pediatrics including pharmacological methods such as NSAIDS and opioids, some non pharmacological methods and .local and regional analgesia