Myriam Bellon1,2,3, Daphné Michelet1,2,3, Nils Carrara1,2,3, Thomas Vacher1,2,3, Benjamin Gafsou1,2,3,4, Brice Ilhareborde5,2,3, Keyvan Mazda5,2,3, Emmanuelle Ferrero5,2,3, Anne-Laure Simon5,2,3, Florence Julien-Marsollier1,2,3, Souhayl Dahmani6,7,8. 1. Department of Anaesthesia, Intensive Care and Pain Management, Robert Debré University Hospital, Paris Diderot University, Paris Sorbonne Cité, 48 Bd Sérurier, 75019, Paris, France. 2. Paris Diderot University, Paris, France. 3. DHU Protect, Robert Debré University Hospital, Paris Diderot University, Paris Sorbonne Cité, Paris, France. 4. Clinique des mousseaux, 2-4 avenue du Mousseau, 91000, Evry, France. 5. Department of Orthpaedic Surgery, Robert Debré University Hospital, Paris Diderot University, Paris Sorbonne Cité, Paris, France. 6. Department of Anaesthesia, Intensive Care and Pain Management, Robert Debré University Hospital, Paris Diderot University, Paris Sorbonne Cité, 48 Bd Sérurier, 75019, Paris, France. souhayl.dahmani@aphp.fr. 7. Paris Diderot University, Paris, France. souhayl.dahmani@aphp.fr. 8. DHU Protect, Robert Debré University Hospital, Paris Diderot University, Paris Sorbonne Cité, Paris, France. souhayl.dahmani@aphp.fr.
Abstract
PURPOSE: The aim of this study was to investigate the opioid-sparing effect of a cooling brace after surgical correction of idiopathic surgery in children. METHODS: We compared two consecutive cohorts of patients before and after introducing this technique in our institution. Management of patients was standardized. The primary objective of the study was to investigate the morphine consumption during the first postoperative day. Secondary outcomes were opioid consumption at day 3, pain intensity (at days 1 and 3), the mobilization in the standing position and duration of hospitalization. RESULTS: This study included 23 and 22 patients in the control and the cooling cohorts. Cooling brace was associated with a significant decrease in morphine consumption at day 1 (1.7 [0.9, 3.3] versus 1.2 [0.5, 3.2] mg kg-1, P = 0.02) and day 3 (2.5 [0.5, 6.7] versus 1.2 [0.9, 2.5] mg kg-1, P = 0.003), and a reduction in duration of hospitalization (4 [3, 6] versus 3 [3, 4] days, P = 0.004). However, no difference was found on the pain intensity or the percentage of patient mobilized in the standing position. Number of level fused and intraoperative opioid consumption were also different between the two cohorts. However, multivariate analysis found only the use of the cooling brace as significantly associated with opioid consumption at day 1. CONCLUSION: The use of this cooling brace allows decreasing the opioid use after surgical correction of idiopathic surgery in children. The current results strongly suggest an interest of this technique in the postoperative management of patients. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: The aim of this study was to investigate the opioid-sparing effect of a cooling brace after surgical correction of idiopathic surgery in children. METHODS: We compared two consecutive cohorts of patients before and after introducing this technique in our institution. Management of patients was standardized. The primary objective of the study was to investigate the morphine consumption during the first postoperative day. Secondary outcomes were opioid consumption at day 3, pain intensity (at days 1 and 3), the mobilization in the standing position and duration of hospitalization. RESULTS: This study included 23 and 22 patients in the control and the cooling cohorts. Cooling brace was associated with a significant decrease in morphine consumption at day 1 (1.7 [0.9, 3.3] versus 1.2 [0.5, 3.2] mg kg-1, P = 0.02) and day 3 (2.5 [0.5, 6.7] versus 1.2 [0.9, 2.5] mg kg-1, P = 0.003), and a reduction in duration of hospitalization (4 [3, 6] versus 3 [3, 4] days, P = 0.004). However, no difference was found on the pain intensity or the percentage of patient mobilized in the standing position. Number of level fused and intraoperative opioid consumption were also different between the two cohorts. However, multivariate analysis found only the use of the cooling brace as significantly associated with opioid consumption at day 1. CONCLUSION: The use of this cooling brace allows decreasing the opioid use after surgical correction of idiopathic surgery in children. The current results strongly suggest an interest of this technique in the postoperative management of patients. These slides can be retrieved under Electronic Supplementary Material.
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