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[Intraoperative and postoperative analgesia in pediatric surgery. 1 years' experience]
M Meignier1, M Zaouter, P Ricard
1Service de Chirurgie Infantile, CHR de Nantes.
Insights
Pediatric anesthesiologists increasingly prioritize pain management. In 1989, 82% of pediatric surgical patients received analgesia, with regional blocks and intravenous narcotics showing no operative complications.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Regional Anesthesia
Background:
- Postoperative pain management is a critical concern in pediatric anesthesiology.
- Untreated pain can lead to significant metabolic and hemodynamic disturbances in children.
- This study reviews analgesic practices in a pediatric department during 1989.
Purpose of the Study:
- To evaluate the department's activity and outcomes in pediatric analgesia during 1989.
- To assess the safety and efficacy of various analgesic techniques used in pediatric surgery.
- To highlight the importance of established protocols and emergency preparedness in pediatric pain management.
Main Methods:
- Retrospective analysis of analgesic administration for 2,675 pediatric surgical patients in 1989.
- Review of techniques including intravenous narcotics and regional blocks (with or without prolonged catheterization).
- Assessment of complications, morbidity, and mortality associated with analgesic interventions.
Main Results:
- 82% of pediatric surgical patients received operative analgesia via intravenous narcotics or regional blocks.
- No operative morbidity or mortality was directly attributed to the analgesic techniques employed.
- Prolonged regional blocks via catheterization resulted in only two seizures, with no major complications.
- Increasing use of morphine across all administration routes was observed.
- Two instances of moderate respiratory depression occurred due to dosage errors, with no lasting consequences.
Conclusions:
- Established protocols and emergency procedures are crucial for ensuring safety in pediatric analgesia.
- Regional blocks and intravenous narcotics are effective and safe methods for operative and postoperative pain management in children.
- Continuous monitoring and adherence to dosage guidelines are essential to prevent adverse events like respiratory depression.
Abstract:
Operative and postoperative analgesia has become in a few years a major concern for pediatric anesthesiologists. The fact that pain can have dramatic metabolic and hemodynamic consequences has been well documented. This study shows the activity in our department in the field of analgesia during 1989. 82% of the 2,675 children having undergone surgery have received analgesia during the operative period either by the way of an i.v. narcotic or an regional block. No morbidity or mortality resulted from these techniques during the operative period. When a regional block was prolonged by the mean of a catheter, there were no major complication (2 seizures). The use of oral, rectal and i.v. analgesics follows the classic recommendations. Morphine by all routes of administration is used increasingly in our department. Two moderate respiratory depressions occurred in 1989 due to error in dosage with no consequence for the child. The authors underline the importance of well established protocols which have been discussed and approved by all, the importance of emergency procedures and treatment, which only can guaranteed the necessary safety.