Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy.

Academic Article

Abstract

  • OBJECT: Postoperative epidural morphine is commonly used to control pain in children following dorsal rhizotomy for spasticity. The authors report their experience in using a regimen of scheduled minor analgesic drugs to manage postoperative pain, with the goal of avoiding opiate use following a spinal intradural procedure. METHODS: Postoperative pain scores were analyzed in a group of 22 children who underwent a partial dorsal rhizotomy. According to a preestablished standard regimen for postoperative pain control after dorsal rhizotomy, in each patient an intraoperative epidural catheter was placed for the potential infusion of postoperative morphine. Additionally, this cohort underwent a scheduled regimen of acetaminophen (10 mg/kg) and ibuprofen (10 mg/kg), alternating every 2 hours. For comparison, a retrospective chart review was performed in 20 patients with rhizotomies completed prior to the use of this oral analgesic protocol. Only one patient received a postoperative dose of morphine epidurally. None of the remaining patients required postoperative epidural morphine for pain control. Pain scores were significantly lower in this group compared with a retrospective review of patients treated according to the standard regimen. Length of hospital stay was shorter in these patients and antiemetic requirements were lower. CONCLUSIONS: A regimen of minor analgesic therapy, when given in alternating doses every 2 hours immediately after partial dorsal rhizotomy for spasticity and throughout hospitalization, significantly reduced postoperative pain scores, hospitalization, and antiemetic requirements in these patients.

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    Published In

    Keywords

  • Acetaminophen, Administration, Oral, Analgesia, Epidural, Analgesics, Analgesics, Opioid, Cerebral Palsy, Child, Child, Preschool, Cohort Studies, Drug Administration Schedule, Female, Health Services Needs and Demand, Humans, Ibuprofen, Male, Morphine, Muscle Spasticity, Pain, Postoperative, Retrospective Studies, Rhizotomy

    • Digital Object Identifier (doi)

    Author List

  • Tubbs RS; Law C; Davis D; Shoja MM; Acakpo-Satchivi L; Wellons JC; Blount JP; Oakes WJ

    • Start Page

  • 439

    • End Page

  • 440

    • Volume

  • 106

    • Issue

  • 6 Suppl