Different Analgesia Techniques for Postoperative Pain in Children Undergoing Abdominal Surgery for Intractable...

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Gastroenterology

Background:

• Functional constipation is common in children, but intractable cases may require surgery.
• Surgical options include ostomy creation or subtotal colectomy.
• Effective perioperative pain management is crucial for pediatric surgical patients.

Purpose of the Study:

• To compare the effectiveness of different perioperative analgesic techniques in children undergoing major abdominal surgery for intractable constipation.
• To identify the optimal pain management strategy for this specific patient population.

Main Methods:

• Retrospective cohort study of patients under 18 undergoing major abdominal surgery for intractable constipation (2011-2021).
• Patients were categorized by perioperative analgesic technique: systemic, neuraxial, or truncal block.
• Postoperative pain was assessed using the numeric rating scale (NRS).

Main Results:

• 65 patients were included; 46 (70.8%) were female, median age 13.5 years.
• Neuraxial analgesia (n=17) resulted in significantly lower postoperative pain (NRS 2.0) compared to systemic analgesia (n=43, NRS 5.0) and truncal blocks (n=5, NRS 5.0).
• P-values for comparisons were < 0.001.

Conclusions:

• Neuraxial analgesia appears most effective in reducing acute postoperative pain for pediatric patients undergoing major abdominal surgery for intractable functional constipation.
• Further well-designed studies are needed to confirm these findings.
• Optimizing pain control can improve recovery outcomes in pediatric surgical patients.