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  1. Home
  2. Comparison Of Opioid Consumption During Paediatric Anaesthesia With And Without A Mandatory Protocol: A Retrospective Cohort Study.
  1. Home
  2. Comparison Of Opioid Consumption During Paediatric Anaesthesia With And Without A Mandatory Protocol: A Retrospective Cohort Study.

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Comparison of Opioid Consumption During Paediatric Anaesthesia with and Without a Mandatory Protocol: A Retrospective

Maciej Kaszyński1, Barbara Stankiewicz2, Aleksandra Kalicka1

  • 1Department of Paediatric Anaesthesiology and Intensive Care, Medical University of Warsaw University Clinical Centre, 02-091 Warsaw, Poland.

Journal of Clinical Medicine
|November 13, 2025

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.

Keywords:
anaesthetic protocolmultimodal anaesthesiaopioid consumptionopioid harmsopioid-sparingopioidspaediatric anaesthesiapain managementstrategies reducing opioid requirements

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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.