Bakgrund: Det är vanligt att patienter inom den kommunala hälso- och sjukvården lider av smärta. Upprepade studier pekar på att validerade smärtskattningsinstrument inte används i någon större utsträckning. Sjuksköterskors bristande kunskap om smärta, smärtskattning och smärtbehandling leder till sämre smärtlindring och försämrad livskvalitet för patienten. Syfte: Studiens syfte är att undersöka sjuksköterskors uppfattning om smärtskattning och smärtskattningsinstrument inom den kommunala hälso- och sjukvården. Metod: En litteraturöversikt valdes för att genomföra studien. I studien ingår elva artiklar som analyserades med kvalitativinnehållsanalys. Resultat: I analysen framkom tre kategorier; kunskap, teamsamverkan och barriärer. Studien visar att sjuksköterskor sällan använder sig av smärtskattningsinstrument i sitt dagliga arbete. De anser att det är svårt att smärtskatta en icke-verbal patient samt de patienter som drabbats av kognitiv svikt. Sjuksköterskor saknar kunskap om smärta och smärtlindring. Det framkommer även flera olika barriärer för smärtskattning så som tidsbrist och personalbrist. Teamet runt patienten ansågs viktigt för att förbättra smärtskattning och smärtbehandling. Slutsats: Resultatet visar att sjuksköterskors kunskaper om smärta och smärtskattning är bristfällig. Arbetslivserfarenhet bidrar inte heller till att sjuksköterskor blir mer benägna att smärtskatta. Det behövs mer utbildning om smärta och smärtskattningsinstrument. / Background: It is common for patients in municipal healthcare to experience pain. Repeated studies indicate that validated pain assessment tools are rarely used. Nurses' lack of knowledge concerning pain, pain assessment and pain relief leads to poor quality pain management which leads to poor quality of life. Aim: The aim of the study was to investigate nurses' opinions of pain assessment and pain assessment tools in municipal healthcare. Method: A literature review was conducted in which eleven scientific studies were examined and analyzed according to qualitative content analysis. Result: Three categories: knowledge, teamwork and barriers, emerged from the analyses. The study shows that nurses rarely use pain assessment tools in their daily work. Nurses generally think it is complicated to assess pain in non- verbal patients or in patients with cognitive impairment. They also feel that they have a lack of knowledge when it comes to pain relief and pain assessment. Other barriers is lack of time and personnel. The multi professional team is seen as an important part to improve pain assessment and pain management. Conclusion: The result points towards the fact that nurses lack skills in pain management. It is not enough to learn from work experience. More extensive education is needed to gain nurses' interest and skills about pain.

Bakgrund: Arton procent av Sveriges befolkning lider av långvarig smärta, men hur stort mörkertalet är vet man inte. Av den äldre befolkningen har 54% kvinnor och 38% män långvarig smärta. Smärtan påverkar flera faktorer, allt från sämre välmående och fysisk trötthet, till påverkan på socialt liv och arbete. Kostnaderna för samhället beräknas varje år kosta 87.5 miljarder kronor i direkta och indirekta kostnader. Komplementär- och alternativmedicin är ett samlingsnamn för behandlingar som inte ingår i den traditionella medicinska behandlingen, bland annat massage, akupunktur, transkutan elektrisk nervstimulering (TENS), kognitiv beteendeterapi (KBT) och meditation/yoga. Syfte: Att beskriva patienters upplevelser och positiva effekter av alternativ- och komplementärmedicin vid långvarig smärta.  Metod: Studien genomfördes i form av en litteraturöversikt och baserades på 14 vetenskapliga artiklar med kvalitativ eller kvantitativ ansats. Sökningarna gjordes i databaserna CINAHL och PubMed.  Resultat: Tre huvudteman framkom i resultatet vilket var ökat välbefinnande, smärtlindring och ökad rörelseförmåga. Studierna visade att patienterna upplevde god smärtlindring och ökad livskvalité både fysiskt och psykiskt vid behandling med komplementär- och alternativmedicin. Patienter som inte uppnått smärtlindring genom den traditionella vården upplever god smärtlindring med hjälp komplementär- och alternativmedicin.  Slutsats: Komplementär- och alternativmedicin kan vara ett alternativ till traditionell behandling och ibland även ett första alternativ av flera anledningar, bland annat för att undvika biverkningar från läkemedel. / Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion:  Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

Background: Acute pain is a globally occurring reason for inpatient suffering and the most common treatment is different forms of analgesics prescribed by doctors. The aim of this study is to identify effects of various non-pharmacological pain relief methods the registered nurse can offer patients with acute pain.   Method: This study is performed as a literature review to examine up to date evidence for non pharmacological pain relief alternatives. The literature search was made in the databases CINAHL, Cochrane and PubMed. A total of ten randomized controlled trial and three quasi experimental studies were included.   Results: When the studies were reviewed significant results were seen for complementary therapies. The results of the included studies showed that complementary therapies, such as cryotherapy, analgesic enhancement, massage, pain dissipation and activity, are effective non-pharmacologic alternatives the registered nurse can offer their patients. Included studies show few negative side effects and could be cost effective. Most of the included methods are easy to use and cost effective, while others are more complicated, expensive and need education to perform.   Conclusion: The study finds that several alternative pain relief methods, available for the registered nurse to offer, give effective relief for inpatients with acute pain. The knowledge of non pharmacological pain relief methods need to be encouraged when training to be a nurse and in the workfield of registered nurses. More research in the area is required to increase the evidence of the methods. / Bakgrund: Akut smärta är en globalt förekommande orsak till lidande hos människor och den vanligaste behandlingen är olika former av analgetika som förskrivs av läkare. Syftet med denna studie är att undersöka effekterna av olika icke-farmakologiska smärtlindringsmetoder som sjuksköterskan kan erbjuda inneliggande patienter.   Metod: Studien utformas som en litteraturöversikt för att undersöka aktuell evidens för icke-farmakologiska smärtlindringsalternativ. Sökningar gjordes i databaserna CINAHL, Cochrane och PubMed. Totalt inkluderades tio randomiserade kontrollerade studier och tre kvasiexperimentella studier.     Resultat: Efter granskning av studierna framkommer signifikanta resultat för smärtlindrande effekter av icke-farmakologisk smärtlindring. De inkluderade studiernas resultat visar att alternativa smärtlindringsmetoder, som kyla och värme, analgetikaförstärkning, massage, smärtavledning och aktivitet är effektiva komplement som sjuksköterskan kan erbjuda sina patienter. De studier som inkluderats beskriver dessutom få negativa effekter och vissa kostnadsbesparingar. De flesta icke-farmakologiska metoderna är enkla och kostnadseffektiva, medan andra är mer komplicerade, kräver utbildning och är kostsamma.   Slutsats: Studien finner att det finns flera effektiva icke-farmakologiska smärtlindringsmetoder, som sjuksköterskan kan erbjuda inneliggande patienter med akut smärta. Kunskaperna om icke-farmakologiska smärtlindringsalternativ inom sjuksköterskeutbildningarna bör uppdateras samt uppmuntras mer ute på avdelningarna. Vidare forskning inom området är nödvändigt för att öka evidensen ytterligare.

Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

<p><strong>Bakgrund:</strong> Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka.</p><p><strong>Syfte:</strong> Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn.</p><p><strong>Metod:</strong> Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys.</p><p><strong>Resultat:</strong> Utifrån analysen framkom tre kategorier och sju subkategorier. De tre kategorierna var: Att skapa kontakt är en utmaning, Helhetstänkande och Rutiner.  Det var en utmaning för anestesisjuksköterskan att skapa kontakt med ett barn som varit sövd. Det var viktigt att alla personalgrupper samt föräldrar samarbetade, och den egna erfarenheten var den viktigaste källan till kunskap samt att det fanns brister gällande skriftliga rutinbeskrivningar.Diskussion: Det är viktigt att det finns tydliga rutiner som underlättar smärtlindringen av barn postoperativt och barn bör bedöma den egna smärtan i så stor utsträckning som möjligt. Det var viktigt att ha en god planering t.ex. att påbörja smärtlindringen tidigt. Stress och oro innan operation kunde ge effekter långt tid efter. Föräldrarna var viktiga och skall involveras i vården för att vara ett stöd för sitt barn. Barn kan reagera kraftigt på anestesiläkemedel och därför bör de väckas långsamt och under lugna förhållanden.</p> / <p><strong>Background:</strong> To prevent, assess and treat pain is central to anesthesia nurses work. Children's experiences and expression of pain are very different from adults. It is therefore a major challenge for anesthesia nurses to interpret children's expressions and emotions in order to understand the child, and to offer security and pain relief. Research has shown that children's postoperative pain is undertreated, despite that the knowledge of children's pain has increased. By highlighting anesthesia nurses’ experiences the understanding may increase concerning factors that contributes to a good or not so good postoperative pain relief in children.</p><p><strong>Objective:</strong> The purpose of this study was to describe anesthesia nurses' experiences when caring for children with a need of postoperative pain relief.</p><p><strong>Method:</strong> Semi-structured interviews were carried out with eight anesthesia nurses at a county hospital in the north central part of Sweden. Collected data was analyzed with a manifest content analysis.</p><p><strong>Results:</strong> From the analysis three categories and seven sub-categories emerged. The three categories were: To create communication is a challenge, Holistic thinking and Routines.  It was a challenge for the anesthesia nurses to communicate with a child that has been put to sleep. It was also of importance that all healthcare staff and parents cooperated. The anesthesia nurses own experiences was the main source of knowledge and there was a shortage of written routine descriptions.Discussion: It is of importance to have clear procedures to facilitate pain relief of children postoperatively and children should assess their own pain as much as possible. To have a good planning e.g. to initiate pain relief before the operation was also of importance. Stress and anxiety before surgery may have an impact long time after the treatment was over. Parents are important and should be involved in the care so they can support their child. Children may react strongly to the anesthesia drugs and therefore they should be brought back slowly postoperatively and in calm conditions.</p>

Bakgrund: Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka. Syfte: Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn. Metod: Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys. Resultat: Utifrån analysen framkom tre kategorier och sju subkategorier. De tre kategorierna var: Att skapa kontakt är en utmaning, Helhetstänkande och Rutiner.  Det var en utmaning för anestesisjuksköterskan att skapa kontakt med ett barn som varit sövd. Det var viktigt att alla personalgrupper samt föräldrar samarbetade, och den egna erfarenheten var den viktigaste källan till kunskap samt att det fanns brister gällande skriftliga rutinbeskrivningar.Diskussion: Det är viktigt att det finns tydliga rutiner som underlättar smärtlindringen av barn postoperativt och barn bör bedöma den egna smärtan i så stor utsträckning som möjligt. Det var viktigt att ha en god planering t.ex. att påbörja smärtlindringen tidigt. Stress och oro innan operation kunde ge effekter långt tid efter. Föräldrarna var viktiga och skall involveras i vården för att vara ett stöd för sitt barn. Barn kan reagera kraftigt på anestesiläkemedel och därför bör de väckas långsamt och under lugna förhållanden. / Background: To prevent, assess and treat pain is central to anesthesia nurses work. Children's experiences and expression of pain are very different from adults. It is therefore a major challenge for anesthesia nurses to interpret children's expressions and emotions in order to understand the child, and to offer security and pain relief. Research has shown that children's postoperative pain is undertreated, despite that the knowledge of children's pain has increased. By highlighting anesthesia nurses’ experiences the understanding may increase concerning factors that contributes to a good or not so good postoperative pain relief in children. Objective: The purpose of this study was to describe anesthesia nurses' experiences when caring for children with a need of postoperative pain relief. Method: Semi-structured interviews were carried out with eight anesthesia nurses at a county hospital in the north central part of Sweden. Collected data was analyzed with a manifest content analysis. Results: From the analysis three categories and seven sub-categories emerged. The three categories were: To create communication is a challenge, Holistic thinking and Routines.  It was a challenge for the anesthesia nurses to communicate with a child that has been put to sleep. It was also of importance that all healthcare staff and parents cooperated. The anesthesia nurses own experiences was the main source of knowledge and there was a shortage of written routine descriptions.Discussion: It is of importance to have clear procedures to facilitate pain relief of children postoperatively and children should assess their own pain as much as possible. To have a good planning e.g. to initiate pain relief before the operation was also of importance. Stress and anxiety before surgery may have an impact long time after the treatment was over. Parents are important and should be involved in the care so they can support their child. Children may react strongly to the anesthesia drugs and therefore they should be brought back slowly postoperatively and in calm conditions.