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Association of Multimodal Pain Control with Patient-Reported Outcomes in Children Undergoing Surgery

Gwyneth A Sullivan1, Lynn Wei Huang2, Willemijn L A Schäfer2

  • 1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL, USA.

Journal of Pediatric Surgery
|March 22, 2023
PubMed

Insights

Multimodal pain management in children using regional anesthetic blocks and biobehavioral interventions may reduce postoperative nervousness. However, these strategies did not impact functional disability or quality of life.

Area of Science:

  • Pediatric Pain Management
  • Multimodal Analgesia
  • Patient-Reported Outcomes

Background:

  • Assessing current multimodal pain management practices in US children's hospitals.
  • Evaluating the impact of non-opioid strategies on pediatric patient-reported outcomes (PROs).

Purpose of the Study:

  • To describe multimodal pain management techniques used in US children's hospitals.
  • To assess the association between non-opioid pain management and pediatric PROs.

Main Methods:

  • Data from the 18-hospital ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) trial.
  • Non-opioid strategies included preoperative/postoperative analgesics, regional blocks, and biobehavioral interventions.
  • PROs assessed were nervousness, functional disability, and quality of life (HRQoL).

Main Results:

  • 186 patients included; 100% received postoperative analgesics, 73% used biobehavioral interventions.
  • Regional blocks and biobehavioral interventions were associated with reduced postoperative nervousness.
  • No associations found between non-opioid strategies and functional disability or HRQoL.

Conclusions:

  • Postoperative non-opioid analgesic use is widespread; preoperative analgesics and regional blocks are less common.
  • Regional anesthetic blocks and biobehavioral interventions show promise in mitigating pediatric postoperative nervousness.
  • Further research needed to optimize non-opioid strategies for functional outcomes.
Abstract

Keywords:
Biobehavioral techniquesChildrenGastrointestinal surgeryMultimodal pain controlPatient-reported outcomesPediatric

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