Catherine E Ferland1,2,3,4,5,6, Eduardo Vega1,2,7, Pablo M Ingelmo1,2,4,5,6. 1. Department of Anesthesia, McGill University. 2. Chronic Pain Service, Montreal Children's Hospital. 3. Research Institute of the McGill University Health Centre. 4. Shriners Hospital for Children-Canada. 5. Alan Edwards Centre for Research on Pain, Montreal, Québec, Canada. 6. SIMPAR Group, Parma, Italy. 7. Department of Anesthesia, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.
Abstract
PURPOSE OF REVIEW: The evidence regarding the efficacy of analgesics available to guide postoperative pain treatment in pediatric patients is limited. Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications. We will focus on initiatives aiming to provide effective treatment minimizing the use of opioids and preventing the long-term consequences of pain. RECENT FINDINGS: Interpatient variability in postoperative pain is currently managed by applying protocols or by trial and error, thus often leading to patients being either undertreated or overtreated. Few evidence-based reports are available to guide the use of opioid medications in children, including the prescription of opioids after hospital discharge. Using combinations of nonopioid analgesics in a multimodal approach may limit the need for opioids, thus decreasing the risk of toxicity and dose-related side effects. There is a lack of adequate research in this field, and more specifically on identifying which patient is at higher risk of poor postoperative pain management. SUMMARY: Treatment options have evolved in recent years, including the combinations of multimodal regimens and regional anesthetic techniques. Using combinations of nonopioid analgesics in a multimodal approach may limit the need for opioids.
PURPOSE OF REVIEW: The evidence regarding the efficacy of analgesics available to guide postoperative pain treatment in pediatric patients is limited. Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications. We will focus on initiatives aiming to provide effective treatment minimizing the use of opioids and preventing the long-term consequences of pain. RECENT FINDINGS: Interpatient variability in postoperative pain is currently managed by applying protocols or by trial and error, thus often leading to patients being either undertreated or overtreated. Few evidence-based reports are available to guide the use of opioid medications in children, including the prescription of opioids after hospital discharge. Using combinations of nonopioid analgesics in a multimodal approach may limit the need for opioids, thus decreasing the risk of toxicity and dose-related side effects. There is a lack of adequate research in this field, and more specifically on identifying which patient is at higher risk of poor postoperative pain management. SUMMARY: Treatment options have evolved in recent years, including the combinations of multimodal regimens and regional anesthetic techniques. Using combinations of nonopioid analgesics in a multimodal approach may limit the need for opioids.
Authors: Denise D Tran; Patrick C M Brown; Corrin Murphy; Diana Ho; Karen A Hudson; Anna C Wilson; Sarah W Feldstein Ewing Journal: Children (Basel) Date: 2022-05-11
Authors: Don Daniel Ocay; Mandy M J Li; Pablo Ingelmo; Jean A Ouellet; M Gabrielle Pagé; Catherine E Ferland Journal: Pain Res Manag Date: 2020-02-24 Impact factor: 3.037