Efficacy of Analgesic Treatments to Manage Children’s Postoperative Pain After Laparoscopic Appendectomy: Retrospective Medical Record Review

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• 作者：Renee C.B. Manworren ; PhD ; APRN ; BC ; FAANAuthor Vitae ; Connor D. McElligott ; BSAuthor Vitae ; Peter V. Deraska ; BSAuthor Vitae ; James Santanelli ; MPHAuthor Vitae ; Sherry Blair ; MS ; APRN ; CPNPAuthor Vitae ; Kimberly A. Ruscher ; MD ; MPHAuthor Vitae ; Richard Weiss ; MDAuthor Vitae ; Christine Rader ; MDAuthor Vitae ; Christine Finck ; MDAuthor Vitae ; Michael Bourque ; MDAuthor Vitae ; Brendan Campbell ; MDAuthor Vitae
• 关键词：pediatric pain ; postoperative pain management ; laparoscopic appendectomy ; pediatric analgesia ; IV ketorolac
• 刊名：AORN Journal
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：103
• 期：3
• 页码：317.e1-317.e11
• 全文大小：1000 K

文摘

Knowledge of the effectiveness of multimodal analgesic treatments to manage children’s postoperative pain during hospital stays is limited. Our retrospective chart review of a convenience sample of 200 pediatric surgical patients’ pain experiences during the first 24 hours after laparoscopic appendectomy demonstrates the benefits of a multimodal analgesic approach. We found that pediatric patients who received perioperative IV ketorolac in addition to opioids reported statistically significantly lower mean pain intensity (n = 134, mean [M] = 2.9, standard deviation [SD] = 1.7) during the first 24 hours after surgery when compared with the pain intensity of patients who did not receive perioperative IV ketorolac (n = 66, M = 3.7, SD = 1.7, t = 3.14, P = .002). Patients who received perioperative IV ketorolac (M = 0.94, SD = 0.71) also received significantly fewer morphine equivalents of postoperative opioids during the first 24 hours after surgery than those who did not (M = 1.21, SD = 0.78, t = 2.41, P = .02). We will use data from these patients to introduce the potential for a personalized medicine approach to postoperative pain.