Substantial postoperative pain is common among children undergoing laparoscopic appendectomy

M, Tomecka; Bortsov, Andrey V.; Miller, Natalie R.; Solano, Natalie; Narron, John; McNaull, Peggy; Ricketts, Karene; Lupa, Concetta; McLean, Samuel A.

doi:10.1111/j.1460-9592.2011.03711.x

Cited by 43 publications

(36 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If a child was sleeping during the first 15min of PACU admission, the nurses recorded a pain score of zero. This is consistent with routine clinical practice and has been previously reported (13). Furthermore, the primary objective of this report was PACU rescue analgesic requirement, hence cross-sectional (first or arousal and the highest recorded pain scores) were noted for all patients.…”

Section: Methodssupporting

confidence: 93%

See 1 more Smart Citation

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

Yang

Baetzel

Chimbira

et al. 2017

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

Introduction Sleep disordered breathing (SDB) symptoms are associated with increased rates of opioid-induced respiratory depression as well as enhanced nociception. Consequently, practitioners often withhold or administer lower intraoperative doses of opioids out of concern for postoperative respiratory depression. Therefore, SDB may be a critical determinant of analgesic requirement in the post-anesthesia care unit (PACU). We investigated whether preoperative SDB classification was independently associated with need for PACU analgesic intervention in a cross-sectional sample of 985 children who underwent elective, painful ambulatory surgical procedures. Methods Using prospectively collected data, children aged 4–17yr were grouped into two categories based on whether or not they had symptoms of SDB. Perioperative variables were compared between the exposed and control groups using Chi-squared test for categorical or t-test for continuous variables. Logistic regression analysis was used to assess the association between SDB and the odds of requiring PACU IV opioids. Results Children with preoperative SDB symptoms (N=325) compared with the reference group of children who did not have these symptoms had higher rates of PACU analgesic intervention (47.1% vs. 37.4%; p=0.004) and higher mean arousal pain scores (3.7±3.5 vs.1.9±2.9; p<0.001). In our primary multivariable logistic regression model adjusted for a number of variables, preoperative SDB symptoms was associated with a two-fold increased odds of receiving PACU intravenous opioid (OR = 2.01, 95%CI, 1.29–3.12; p=0.002). Conclusion These results suggest that preoperative SDB symptoms in children undergoing ambulatory surgery, exerts a significant influence on PACU pain behavior and analgesic requirement. Mechanisms underlying this enhanced pain experience deserve further elucidation.

show abstract

Section: Methodssupporting

confidence: 93%

“…Several potential predictors of early postoperative pain following ambulatory surgical procedures have been identified (11–13). However, patient-specific predictors of clinically important PACU pain following ambulatory surgery in children have not been comprehensively determined.…”

Section: Introductionmentioning

confidence: 99%

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

Yang

Baetzel

Chimbira

et al. 2017

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

show abstract

“…We found similar results for the initial admission, but we also found a higher re‐presentation rate following laparoscopic appendicectomy for uncomplicated appendicitis. It is possible that children undergoing laparoscopic appendicectomy recover more slowly than is recognised, and that the discomfort of laparoscopy may take time to subside 14 . Children have smaller abdominal cavities than adults, and insufflation with carbon dioxide is often required for a laparoscopic appendicectomy; the additional stretching of the anterior abdominal wall and diaphragm can cause post‐operative discomfort.…”

Section: Discussionmentioning

confidence: 99%

A population‐based comparison of the post‐operative outcomes of open and laparoscopic appendicectomy in children

Schneuer

Adams

Bentley

et al. 2018

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…Moreover, Tomecka et al (13) found that children who underwent LA had a substantial pain at 1: 3 ratio on the first, and 1: 5 on the second postoperative day. Therefore, the development of pain therapy regimens that can be reliably applied to the pediatric patients who have undergone OA as well as to children who are treated with LA is an important need.…”

Section: Discussionmentioning

confidence: 99%

Multimodal analgesia for pediatric patients who underwent open or laparoscopic appendectomy

Özmert¹,

Sever²,

Yalçın³

et al. 2018

BUCH

View full text Add to dashboard Cite

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.

show abstract

Substantial postoperative pain is common among children undergoing laparoscopic appendectomy

Abstract: These preliminary data suggest that substantial postoperative pain is common in children undergoing laparoscopic appendectomy. More studies of postoperative pain outcomes among children undergoing laparoscopic appendectomy and other common pediatric surgical procedures are needed.

Cited by 43 publications

References 29 publications

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

A population‐based comparison of the post‐operative outcomes of open and laparoscopic appendicectomy in children

Multimodal analgesia for pediatric patients who underwent open or laparoscopic appendectomy

Contact Info

Product

Resources

About