Comparison of Opioid Consumption During Paediatric Anaesthesia with and Without a Mandatory Protocol: A Retrospective Cohort Study
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.A standardized anesthesia protocol significantly reduced intraoperative opioid use in pediatric laparoscopic appendectomy. This multimodal approach also increased non-opioid analgesic administration without affecting hospital stay.
Area Of Science
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background
- Opioids are effective analgesics but carry risks of adverse effects.
- Minimizing opioid use is crucial for patient safety and postoperative quality.
- Standardized protocols may offer an opioid-sparing strategy.
Purpose Of The Study
- To evaluate the opioid-sparing potential of a mandatory standardized anesthesia protocol.
- To compare intraoperative opioid consumption in patients undergoing laparoscopic appendectomy with and without the protocol.
Main Methods
- Single-centre retrospective cohort study comparing two groups of patients undergoing laparoscopic appendectomy.
- Group 1: Standardized anesthesia protocol (n=132).
- Group 2: Clinician's discretion (n=212).
- Assessed intraoperative opioid and non-opioid analgesic use, and length of hospital stay.
Main Results
- Significantly lower total fentanyl dose in the standardized protocol group (3.13 μg·kg⁻¹) vs. the non-protocol group (5.19 μg·kg⁻¹).
- Higher administration of acetaminophen (57% increase) and metamizole (23% increase) in the protocol group.
- No significant difference in length of hospital stay between the groups.
Conclusions
- A mandatory multimodal anesthesia protocol demonstrated an opioid-sparing effect in pediatric laparoscopic appendectomy.
- Standardized protocols can enhance the use of non-opioid analgesics.
- This approach may improve postoperative outcomes by reducing opioid-related complications.
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
Related Concept Videos
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...