Dosing of Opioid Medications During and After Pediatric Cardiac Surgery for Children With Down Syndrome
Copyright © 2021 Elsevier Inc. All rights reserved..
OBJECTIVE: To determine whether children with Down syndrome (DS) receive higher doses of opioid medications compared with children without DS for repair of complete atrioventricular canal (CAVC).
DESIGN: A retrospective chart review of children with and without DS who underwent primary repair of CAVC. The exclusion criteria included unbalanced CAVC and patients undergoing biventricular staging procedures. The primary outcome was oral morphine equivalents (OME) received in the first 24 hours after surgery. The secondary outcomes included intraoperative OME, OME at 48 and 72 hours, nonopioid analgesic and sedative medications received, pain scores, time to extubation, and length of stay.
SETTING: A pediatric academic medical center in the United States.
PARTICIPANTS: One hundred thirty-one patients with DS and 24 without, all <two years old, who underwent a CAVC repair.
INTERVENTIONS: Not applicable.
MEASUREMENTS AND MAIN RESULTS: Patients with DS were older than patients without DS (median 96.3 days [interquartile range {IQR} 70.7-128.2] v 75.9 days [IQR 49.8-107.3], p = 0.033) but otherwise not statistically different in the baseline characteristics. There was no difference in OME received in the first 24 hours postoperatively between groups (3.01 mg/kg [IQR 1.23-5.43] v 3.57 mg/kg [IQR 1.54-7.06], p = 0.202). OME at 48 and 72 hours was lower in the DS group compared with the control group. Similar amounts of opioid and non-opioid analgesics and sedatives were otherwise given to both groups of patients. Median pain scores did not differ between groups.
CONCLUSIONS: These results suggested that patients with DS undergoing CAVC repair do not have increased opioid requirements compared with a similar control group.
| Errataetall: |
CommentIn: J Cardiothorac Vasc Anesth. 2022 Jan;36(1):200-201. - PMID 34674930 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Journal of cardiothoracic and vascular anesthesia - 36(2022), 1 vom: 12. Jan., Seite 195-199 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vogel, Elizabeth R [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesia |
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| Anmerkungen: |
Date Completed 31.01.2022 Date Revised 31.01.2022 published: Print-Electronic CommentIn: J Cardiothorac Vasc Anesth. 2022 Jan;36(1):200-201. - PMID 34674930 Citation Status MEDLINE |
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| doi: |
10.1053/j.jvca.2021.08.019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 500 | |a CommentIn: J Cardiothorac Vasc Anesth. 2022 Jan;36(1):200-201. - PMID 34674930 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To determine whether children with Down syndrome (DS) receive higher doses of opioid medications compared with children without DS for repair of complete atrioventricular canal (CAVC) | ||
| 520 | |a DESIGN: A retrospective chart review of children with and without DS who underwent primary repair of CAVC. The exclusion criteria included unbalanced CAVC and patients undergoing biventricular staging procedures. The primary outcome was oral morphine equivalents (OME) received in the first 24 hours after surgery. The secondary outcomes included intraoperative OME, OME at 48 and 72 hours, nonopioid analgesic and sedative medications received, pain scores, time to extubation, and length of stay | ||
| 520 | |a SETTING: A pediatric academic medical center in the United States | ||
| 520 | |a PARTICIPANTS: One hundred thirty-one patients with DS and 24 without, all <two years old, who underwent a CAVC repair | ||
| 520 | |a INTERVENTIONS: Not applicable | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Patients with DS were older than patients without DS (median 96.3 days [interquartile range {IQR} 70.7-128.2] v 75.9 days [IQR 49.8-107.3], p = 0.033) but otherwise not statistically different in the baseline characteristics. There was no difference in OME received in the first 24 hours postoperatively between groups (3.01 mg/kg [IQR 1.23-5.43] v 3.57 mg/kg [IQR 1.54-7.06], p = 0.202). OME at 48 and 72 hours was lower in the DS group compared with the control group. Similar amounts of opioid and non-opioid analgesics and sedatives were otherwise given to both groups of patients. Median pain scores did not differ between groups | ||
| 520 | |a CONCLUSIONS: These results suggested that patients with DS undergoing CAVC repair do not have increased opioid requirements compared with a similar control group | ||
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| 700 | 1 | |a DiNardo, James A |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Morgan L |e verfasserin |4 aut | |
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