A retrospective study of multimodal analgesic treatment after laparoscopic appendectomy in children

Liu, Yang; Seipel, Catherine P.; López, Mónica E.; Nuchtern, Jed G.; Brandt, Mary L.; Fallon, Sara C.; Manyang, Peter; Tjia, Imelda; Baijal, Rahul G.; Watcha, Mehernoor F.

doi:10.1111/pan.12271

Cited by 36 publications

(46 citation statements)

References 19 publications

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“…Pain after appendicectomy was more severe than has been previously reported with 68% and 70% of children experiencing moderate or severe pain after open and laparoscopic procedures, respectively . Tomecka et al.…”

Section: Discussionmentioning

confidence: 85%

A prospective audit of pain profiles following general and urological surgery in children

Wilson

Sommerfield

Drake‐Brockman

et al. 2017

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 85%

A prospective audit of pain profiles following general and urological surgery in children

Wilson

Sommerfield

Drake‐Brockman

et al. 2017

Pediatric Anesthesia

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“…In our study, we think that reaching the same pain level of LA group in the OA group depends on the local bupivacaine effect. Similarly in a retrospective study, Liu et al (26) reported that using multimodal analgesia with local anesthesia was effective in reducing pain in pediatric patients following laparoscopic appendectomy.…”

Section: Discussionmentioning

confidence: 94%

Multimodal analgesia for pediatric patients who underwent open or laparoscopic appendectomy

Özmert¹,

Sever²,

Yalçın³

et al. 2018

BUCH

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Objective: The aim of this study is to show the results of the implementation of a multimodal pain therapy regimen consisting of preemptive and infiltration analgesia application to laparoscopic or open appendectomy in pediatric patients. Methods: Eighty pediatric patients with diagnosis of acute and perforated appendicitis, who scheduled for laparoscopic or open appendectomy were randomly separated into 2 groups of 40. Age, sex, and weight of the patients, duration of anesthesia and surgical techniques were recorded. Preemptive 1.5 mg/kg tramadol HCl was administered at induction of anesthesia. As infiltration anesthesia 1 mg/kg 0.5% bupivacaine HCl was administered to the incision site of all patients. The pain levels of the patients after extubation were evaluated with Children's Hospital of Eastern Ontorio Pain Scale and Visual Analog Scale. The heart rates, respiratory rates, sedation score values, diastolic and systolic blood pressure values, postoperative analgesic requirements, sedation scores, the observed side effects, hospital stay, and the time of the first mobilization were recorded and compared. Results: There were no statistically significant differences between the groups with respect to monitored parameters except operation time and anesthesia time. Postoperative first day 13 patients (32.5%) in the LA group and in 9 patients (22.5%) in OA group, while on the second day only 2 patients (%5) in the OA group required additional analgesia . Conclusion: Our multimodal analgesia protocol consisting of preemptive analgesia and perioperative local anesthesia infiltration showed no difference between patients who underwent laparoscopic or open appendectomy with respect to pain levels and analgesic requirements.

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“…A study of patients undergoing orthopedic surgery found that intravenous acetaminophen improved pain relief and reduced morphine analgesic use compared with placebo [151]. In addition, a retrospective study of pediatric emergency appendectomy patients found that multimodal analgesia including NSAIDs or acetaminophen alongside morphine delivered by a patient-controlled analgesia device significantly reduced the number of patients reporting substantial pain [154]. In a study by Zare and colleagues [155], intravenous acetaminophen plus oral oxycodone was found to provide similar pain relief to intravenous morphine in patients with bone fractures.…”

Section: New Therapeutic Options For the Management Of Acute Painmentioning

confidence: 97%

Improving acute pain management in emergency medicine

Pollack

Viscusi

2015

Hospital Practice

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Undertreatment of pain (oligoanalgesia) in the emergency department is common, and it negatively impacts patient care. Both failure of appropriate pain assessment and the potential for unsafe analgesic use contribute to the problem. As a result, achieving satisfactory analgesia while minimizing side effects remains particularly challenging for emergency physicians, both in the emergency department and after a patient is discharged. Improvements in rapid pain assessment and in evaluation of noncommunicative populations may result in a better estimation of which patients require analgesia and how much pain is present. New formulations of available treatments, such as rapidly absorbed, topical, or intranasal nonsteroidal anti-inflammatory drug formulations or intranasal opioids, may provide effective analgesia with an improved risk-benefit profile. Other pharmacological therapies have been shown to be effective for certain pain modalities, such as the use of antidepressants for musculoskeletal pain, γ-aminobutyric acid agonists for neuropathic and postsurgical pain, antipsychotics for headache, and topical capsaicin for neuropathic pain. Nonpharmacological methods of pain control include the use of electrical stimulation, relaxation therapies, psychosocial/manipulative therapies, and acupuncture. Tailoring of available treatment options to specific pain modalities, as well as improvements in pain assessment, treatment options, and formulations, may improve pain control in the emergency department setting and beyond.

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A retrospective study of multimodal analgesic treatment after laparoscopic appendectomy in children

Cited by 36 publications

References 19 publications

A prospective audit of pain profiles following general and urological surgery in children

A prospective audit of pain profiles following general and urological surgery in children

Multimodal analgesia for pediatric patients who underwent open or laparoscopic appendectomy

Improving acute pain management in emergency medicine

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