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Strategies for preventing side effects of systemic opioid in postoperative pediatric patients

Thanaporn Jitpakdee1, Sahatsa Mandee

  • 1Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.

Paediatric Anaesthesia
|May 10, 2014
PubMed

Insights

Minimizing opioid use through multimodal approaches, titration, and local anesthesia can effectively reduce side effects like vomiting and constipation in pediatric patients. Specific prophylaxis further aids in managing adverse events during postoperative pain management.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Pain Management

Background:

  • Opioids are standard for moderate-to-severe pediatric pain but cause significant side effects.
  • Common opioid side effects include vomiting (40%), pruritus (20-60%), and constipation (15-90%).
  • Life-threatening respiratory depression is rare (0.0013%).

Purpose of the Study:

  • To review strategies for preventing and reducing opioid side effects in pediatric patients postoperatively.
  • To identify effective methods for improving pain management outcomes.

Main Methods:

  • Conducted literature searches from 1984 to February 2013.
  • Included meta-analyses, systematic reviews, and randomized controlled trials from PubMed and Cochrane Library.
  • Utilized MeSH terms: opioid analgesics, adverse effects, pediatrics, children, side effects, postoperative pain.

Main Results:

  • Reviewed data from 62 studies.
  • Identified strategies to prevent and reduce opioid side effects.
  • Multimodal approaches, opioid titration, and local anesthetic techniques were effective.

Conclusions:

  • Minimizing opioid consumption is key.
  • Multimodal analgesia and opioid titration reduce side effects.
  • Local anesthetic techniques and specific prophylaxis are crucial for managing pediatric postoperative pain and opioid adverse events.
Abstract

Keywords:
adverse effectschildmultimodal treatmentopioid analgesicspainpediatricspostoperative

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