BACKGROUND: The purpose of this investigation was to determine whether there is an association between high body mass index (BMI) in children and the occurrence of early post-tonsillectomy pain (PTP). The hypothesis tested was that high BMI is associated with increased severity of early PTP. METHODS: We extracted data on all children aged 3-17 years that underwent adeno-tonsillectomy (T&A) over a 2-year period from our anesthesia clinical information system. Patients were classified into normal or high BMI group and early PTP scores were compared between the groups. Clinically significant (moderate-severe) early PTP was defined as pain score ≥ 4 within the first 15 min of admission to the post-anesthesia care unit (PACU). RESULTS: Among 462 patients, 35.1% were overweight or obese. The overall incidence of moderate to severe early PTP was 23.6%. All the patients received at least one or more intraoperative opioid (morphine 94.2% and fentanyl 21.9%). Compared to those in the normal BMI group, children with moderate-severe PTP were older, female and more likely to be overweight or obese. Children with high BMI had significantly higher unadjusted odds of having moderate-severe early post-tonsillectomy pain (48.9% vs. 14.1%, OR=7.01, 95% CI=3.9-12.8, p<0.001). After controlling for several clinically relevant covariates, high BMI was the most consistent risk factor for moderate to severe early PTP in this cohort of children. CONCLUSION: These results indicate that high BMI in children is associated with increased early PTP. The mechanism(s) underlying this association deserve further elucidation. Published by Elsevier Ireland Ltd.
BACKGROUND: The purpose of this investigation was to determine whether there is an association between high body mass index (BMI) in children and the occurrence of early post-tonsillectomy pain (PTP). The hypothesis tested was that high BMI is associated with increased severity of early PTP. METHODS: We extracted data on all children aged 3-17 years that underwent adeno-tonsillectomy (T&A) over a 2-year period from our anesthesia clinical information system. Patients were classified into normal or high BMI group and early PTP scores were compared between the groups. Clinically significant (moderate-severe) early PTP was defined as pain score ≥ 4 within the first 15 min of admission to the post-anesthesia care unit (PACU). RESULTS: Among 462 patients, 35.1% were overweight or obese. The overall incidence of moderate to severe early PTP was 23.6%. All the patients received at least one or more intraoperative opioid (morphine 94.2% and fentanyl 21.9%). Compared to those in the normal BMI group, children with moderate-severe PTP were older, female and more likely to be overweight or obese. Children with high BMI had significantly higher unadjusted odds of having moderate-severe early post-tonsillectomy pain (48.9% vs. 14.1%, OR=7.01, 95% CI=3.9-12.8, p<0.001). After controlling for several clinically relevant covariates, high BMI was the most consistent risk factor for moderate to severe early PTP in this cohort of children. CONCLUSION: These results indicate that high BMI in children is associated with increased early PTP. The mechanism(s) underlying this association deserve further elucidation. Published by Elsevier Ireland Ltd.
Authors: S Sadhasivam; V Chidambaran; X Zhang; J Meller; H Esslinger; K Zhang; L J Martin; J McAuliffe Journal: Pharmacogenomics J Date: 2014-10-14 Impact factor: 3.550
Authors: Kamie Yang; Anne Baetzel; Wilson T Chimbira; Yuliya Yermolina; Paul I Reynolds; Olubukola O Nafiu Journal: Int J Pediatr Otorhinolaryngol Date: 2017-03-19 Impact factor: 1.675