Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps.
Analgesia
cardiac surgery
infants
nonopioid
nonsteroidal anti-inflammatory drugs
pediatric
postoperative care
Journal
Annals of pediatric cardiology
ISSN: 0974-2069
Titre abrégé: Ann Pediatr Cardiol
Pays: India
ID NLM: 101495459
Informations de publication
Date de publication:
Historique:
received:
19
12
2018
revised:
05
06
2019
accepted:
08
10
2019
entrez:
8
2
2020
pubmed:
8
2
2020
medline:
8
2
2020
Statut:
ppublish
Résumé
The purpose of this review is to present the available literature on the use of nonopioid analgesics such as nonsteroidal anti-inflammatory drugs in postcardiac surgery pediatric patients, mainly to focus on patients <1 year of age, and to provide the foundation for future research. Published studies that address the use on nonopioid medications for postoperative sedation and analgesia in infants and children undergoing cardiac surgery were identified from online sources. Studies were reviewed by two authors independently to assess the quality of the data as well as the evidence. Due to limited availability of such studies, the review was then expanded to include use in noncardiac procedures as well as to expanded age groups. All studies that met the primary objective were included. Majority of the studies in the population of interest were related to use of ketorolac. Five studies specifically addressed ketorolac use in cardiac patients. In addition, studies were reviewed for nonopioid analgesia in noncardiac patients and included as a part of the available evidence as in the case of acetaminophen use. Newer agents as well as agents with very limited information were also acknowledged. Nonopioid medications appear to show promise for analgesia in infants undergoing cardiac surgery, with ketorolac being the most potent agent as a potential substitute for opioids. These agents demonstrate a reasonable safety profile even in the very young. There continue to be significant gaps in knowledge before their adoption becomes routine. However, gives the awareness regarding short-term and long-term impact of opioid use in this vulnerable population, and studies of such agents are an urgent need.
Identifiants
pubmed: 32030035
doi: 10.4103/apc.APC_190_18
pii: APC-13-46
pmc: PMC6979012
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
46-55Informations de copyright
Copyright: © 2019 Annals of Pediatric Cardiology.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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