{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T08:55:31Z","timestamp":1762160131570,"version":"build-2065373602"},"reference-count":26,"publisher":"Brieflands","issue":"4","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["brieflands.com"],"crossmark-restriction":false},"short-container-title":["Anesth Pain Med"],"abstract":"<jats:p>Background: Regarding post-adenotonsillectomy pain management, pediatric patients with severe obstructive sleep apnea (OSA) are often treated with lower total opioid doses, and with more short-acting opioid types, relative to their non-severe OSA counterparts. It is unclear whether this practice undermines these patients\u2019 pain management and exposes them to a traumatic experience due to under-managed surgical pain. Pain sensitivity differs between adult males and females. Whether the difference exists in the pediatric population, especially related to surgical pain sensitivity, is unclear. Objectives: We explored the differences in pain sensitivity between sexes using a pediatric adenotonsillectomy population and studied the effects of sleep apnea on acute pain responses. Methods: We retrospectively analyzed perioperative pain management approaches in a pediatric adenotonsillectomy surgical population at our medical center. Patients aged 3 to 12 years were grouped into those with less severe OSA or severe OSA. Perioperative pain medications and post-anesthesia care unit (PACU) pain assessments were compared between two groups. Results: Of a total 3,586 patients we analyzed, a higher percentage of severe OSA patients received non-opioid type analgesic medications, as well as fewer and shorter-acting opioids. The use of rescue opioids in the post-operative period did not significantly increase in patients with severe OSA. Post-operative pain scores did not differ between patients with and without severe OSA status. Female patients had significantly higher post-operative pain scores than males in the less severe OSA group, but sex differences in the severe OSA group were not significant. Conclusions: Despite receiving less perioperative opioid, pediatric patients with severe OSA did not demonstrate worse pain scores in post-surgical recovery. Overall, we did not under-manage their post-operative pain with reduced dosages of opioids. We did find that a sex difference in acute pain perception exists even in pre-puberty pediatric population. However, severe OSA reduces pain sensitivity in both sexes, and blunts sex differences in acute pain perception.<\/jats:p>","DOI":"10.5812\/aapm-163436","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T10:23:28Z","timestamp":1755685408000},"update-policy":"https:\/\/doi.org\/10.5812\/crossmark_update_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Study on Pain Sensitivity in Pediatric Patients with Severe Obstructive Sleep Apnea Undergoing 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