Low-Dose Versus High-Dose Postoperative Naloxone Infusion Combined With Patient-Controlled Analgesia for Adolescent Idiopathic Scoliosis Surgery: A Randomized Controlled Trial

Pieters, Benjamin J.; Anderson, John T.; Price, Nigel; Anson, Lynn; Schwend, Richard M.

doi:10.1016/j.jspd.2018.01.005

Cited by 11 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, the use of IV naloxone is not associated with any significant changes in opioid consumption nor with the risk of sedation or emesis [3,44]. In other more recent study, low and ultra-low doses such as 0.25 µg/kg are also reported to reduce pain intensity due to morphine consumption, pruritus and nausea [45,46]; finally, Pieters [47] found that a high dose naloxone of 0.5 mg/kg/h was not more efficient in reducing opioid side effects, despite partially reversing the analgesic effect of opioid by yielding an increase in demand on postoperative day 2.…”

Section: Side Effects Of Iv-pcamentioning

confidence: 90%

“…Opioid infusions in children are useful, but adequate dosing and titration require careful supervision. Nevertheless, morphine titration in pediatrics has limitations, as pain scores are not always obtainable in the PACU and the validity of self-reported pain intensity scores may be unreliable in children with developmental and neurological disabilities, thereafter affecting the analgesic protocol and necessitating close monitoring [47,48].…”

Section: Pca In Childrenmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain

Motamed

2022

Pharmacy

View full text Add to dashboard Cite

Patient-controlled analgesia (PCA) is an effective method for controlling acute pain, including postoperative pain in adults and in children from five years of age, pain resulting from labor, trauma, or other medical situations, or chronic and malignant pain. The treatment consists of a mini-computer-controlled infusion pump permitting the administration of on-demand, continuous, or combined doses of analgesic (mainly opioid) variations in response to therapy, which allows pain to be significantly controlled. Intravenous (IV)-PCA minimizes individual pharmacodynamics and pharmacokinetic differences and is widely accepted as a reference method for mild or severe postoperative pain. IV-PCA is the most studied route of PCA; other delivery methods have been extensively reported in the literature. In addition, IV-PCA usually voids the gap between pain sensation and analgesic administration, permitting better recovery and fewer side effects. The most commonly observed complications are nausea and vomiting, pruritus, respiratory depression, sedation, confusion and urinary retention. However, human factors such as pharmacy preparation and device programming can also be involved in the occurrence of these complications, while device failure is much less of an issue.

show abstract

Section: Side Effects Of Iv-pcamentioning

confidence: 90%

Section: Pca In Childrenmentioning

confidence: 99%

Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain

Motamed

2022

Pharmacy

View full text Add to dashboard Cite

show abstract

“…A retrospective study conducted by Pieters et al [31] reported ten kids who were administered IT morphine. All patients received lumbar intrathecal injections of preservative-free morphine (Duramorph®) at a dose of 0.02 mg/kg prior to the start of surgery.…”

Section: Effect Of Epidural and Intrathecal Morphine 3611 In Childrenmentioning

confidence: 99%

Epidural or intrathecal morphine for post-operative analgesia following laparoscopic endometriosis surgery

Shetty¹,

Gupta²,

Shetty³

2022

Int. J. Med. Anesthesiology

View full text Add to dashboard Cite

Background: Endometriosis is the development of endometrial glands or stroma outside the uterine cavity, in the pelvis, ovaries, and fallopian tubes. Laproscopy is the most common method used in management of endometriosis and it also eliminates endometriosis-related scar tissue, implants, and cysts. Epidural or intrathecal morphine is an effective way to alleviate post-operative pain after laparoscopic endometriosis surgery. Methods: Literature search was conducted in three electronic databases-Google Scholar, Cochrane (Controlled Trials Register), and PubMed (MEDLINE/Index Medicus). Postoperative pain, epidural and intrathecal morphine, laparoscopy surgery, patient-controlled analgesia (PCA), opioids, and morphine were the search criteria used. Results: After removing duplicate studies, the search yielded 106 results. Out of which50 full-text publications that matched the inclusion criterion were retrieved. Conclusion: Single intrathecal morphine injection is safe and effective in managing post-operative pain, however continuous epidural analgesia is risky and difficult to manage after laparoscopic endometriosis surgery.

show abstract

“…Of note, investigations using IV naloxone (0.5mcg/kg/hr) to mitigate opioid-related side effects of pruritis, nausea, vomiting, and respiratory depression have shown limited efficacy against pruritis and nausea, but other outcomes were nonsigificant. [8][9] Considering the high incidence of PONV and pruritis, other techniques described later in this review have been investigated to supplement IV PCA to minimize morphine use.…”

Section: Morphinementioning

confidence: 99%

Postoperative Analgesia After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Shah¹,

Pey²,

Bowen³

et al. 2021

Journal of the Pediatric Orthopaedic Society of North America

View full text Add to dashboard Cite

PSF for AIS are young women who are particularly susceptible to pain. 1 Current postoperative pain management strategies are diverse and multimodal, with variation in analgesic efficacy as well as adverse events. The purpose of this current concept review is to synthesize all available data from randomized and observational studies to provide a comprehensive overview of the use and key advantages of different analgesic treatment modalities after posterior spinal fusion in patients with adolescent idiopathic scoliosis.

show abstract

Low-Dose Versus High-Dose Postoperative Naloxone Infusion Combined With Patient-Controlled Analgesia for Adolescent Idiopathic Scoliosis Surgery: A Randomized Controlled Trial

Abstract: Level 1.

Cited by 11 publications

References 9 publications

Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain

Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain

Epidural or intrathecal morphine for post-operative analgesia following laparoscopic endometriosis surgery

Postoperative Analgesia After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Contact Info

Product

Resources

About