Postoperative pain control with paravertebral catheters after pediatric total pancreatectomy and islet autotransplantation: a retrospective cohort study
| Autor: | Jacob L Hutchins, Qi Wang, Srinath Chinnakotla, Chandra Castro |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Catheters Adolescent medicine.medical_treatment Islets of Langerhans Transplantation Transplantation Autologous Cohort Studies 03 medical and health sciences 0302 clinical medicine Pancreatectomy 030202 anesthesiology medicine Humans Pain Management Ropivacaine Anesthetics Local Child Retrospective Studies geography Pain Postoperative geography.geographical_feature_category business.industry Medical record Chronic pain Retrospective cohort study Nerve Block Islet medicine.disease Amides Autotransplantation Surgery Anesthesiology and Pain Medicine Treatment Outcome Pancreatitis Anesthesia Pediatrics Perinatology and Child Health Morphine 030211 gastroenterology & hepatology Female business medicine.drug |
| Zdroj: | Paediatric anaesthesia. 26(3) |
| ISSN: | 1460-9592 |
| Popis: | Summary Background Total pancreatectomy and islet autotransplantation (TPIAT) has been used to treat pediatric patients with chronic pancreatitis. The primary symptom of this disease is extreme poorly controlled pain. This results in significant alterations in the quality of life of the patient. We sought to determine if the addition of bilateral thoracic paravertebral catheters with continuous ropivacaine infusion would improve postoperative opioid use and pain control. Methods The medical records of 32 patients who underwent TPIAT from March 2011 to July 2014 were analyzed retrospectively (15 without paravertebral catheters and 17 with paravertebral catheters). Maximum and minimum pain scores, opioid use (mg·kg−1·day−1), percent opioid use above baseline, length of stay, and complications were recorded. Results Those patients who had bilateral thoracic paravertebral catheters had decreased total opioid use in the first 7 days postoperatively when compared to those who did not (612 (95% CI: 432–792) vs 943.7 (95% CI: 650–1237) mg of morphine equivalents; P = 0.043). The total opioid use remained significantly decreased when corrected for weight (12.53 (95% CI: 9.19–15.44) vs 18.85 (95% CI: 13.69–24.03) mg·kg−1 of morphine equivalents; P = 0.03). In addition, those on preoperative opioids had less percent opioid use above baseline on postoperative days 1, 2, and 7 as well as decreased opioid use (mg·kg−1·day−1) on postoperative days 1, 2, 3, and 7. There were no differences in complications or length of stay. Conclusions Bilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT. |
| Databáze: | OpenAIRE |
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