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Interventions for postoperative pain in children: An overview of systematic reviews

Krste Boric1, Svjetlana Dosenovic2, Antonia Jelicic Kadic3

  • 1Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.

Paediatric Anaesthesia
|July 15, 2017
PubMed

Insights

This overview of systematic reviews found inconclusive evidence for most pediatric postoperative pain management strategies. More high-quality trials are needed to confirm the efficacy and safety of various interventions.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Evidence-Based Medicine

Background:

  • Postoperative pain in children requires effective and safe management strategies.
  • Numerous interventions exist, but their efficacy and safety require robust summarization.
  • Systematic reviews provide a foundation for evaluating these interventions.

Purpose of the Study:

  • To conduct an overview of systematic reviews on the efficacy and safety of postoperative pain management in children.
  • To synthesize evidence from randomized controlled trials (RCTs) on various pain management strategies.
  • To identify gaps in the evidence and guide future research.

Main Methods:

  • Searched multiple databases (Cochrane, CINAHL, Embase, MEDLINE, PsycINFO) up to January 2016.
  • Included 45 systematic reviews evaluating interventions for pediatric postoperative pain.
  • Assessed the methodological quality of included systematic reviews.

Main Results:

  • 19 (42%) systematic reviews presented conclusive evidence of efficacy for interventions like diclofenac, ketamine, and epidural analgesia.
  • 14 (31%) systematic reviews reported conclusive safety data for interventions including dexmedetomidine and transversus abdominis plane block.
  • Most systematic reviews had medium methodological quality; Cochrane reviews were of higher quality.

Conclusions:

  • Evidence for the efficacy and safety of most pediatric postoperative pain management interventions remains inconclusive.
  • There is a significant need for more rigorous, high-quality randomized controlled trials.
  • This overview highlights the current limitations in evidence and directs future research efforts.

Keywords:
analgesiachildmethodspain managementpostoperative painreview

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