Supervisors info:
Παρασκευά Άντεια, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Τσαρουχά Αθανασία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γαρίνη Ελεάνα, Επιμελήτρια Α ΕΣΥ
Summary:
Introduction: Acute postoperative pain is a frequent and stressful
condition both for adults and children. Opioids are widely used for postoperative
pain, but they have some serious risks raising concern for their use in pediatric
surgical patients. Multimodal analgesic therapy is necessary to provide
appropriate comfort for the patients after surgery and assumes that effective
control of postoperative pain is achieved using different analgesics (opioids,
NSAID, opioid-sparing analgesics) so that they act synergistically. The goal of
this approach is to reduce opioid and other drugs administration and their
related adverse effects.
Purpose: The systematic literature review of the use and efficacy of
systemic opioid-sparing analgesics (gabapentinoids, corticosteroids, a2
agonists, NMDA receptors antagonists, local anesthetics) for postoperative
analgesia in pediatric surgical populations.
Materials and Methodology: Pubmed-Medline and Cochrane Library
were searched for the time period from 2015 to 2020. Key words which have
been used was “Pediatric, children, pain, analgesia, placebo, control, clonidine,
dexmedetomidine, dexamethasone, ketamine, pregabalin, gabapentin,
magnesium, lidocaine ” and their combinations.
Results: 27 studies were included in the review. 4 of them were referred
to dexamethasone, 1 for clonidine, 7 for dexmedetomidine, 2 for ketamine, 1
for magnesium, 6 for lidocaine, 4 for gabapentin and 2 for pregabalin.
Conclusions: Current evidence suggests that dexamethasone,
clonidine and dexmedetomidine decrease postoperative pain and opioid
consumption in some pediatric surgical populations. There are too limited
evidence to draw conclusions on the use and efficacy of lidocaine, magnesium,
ketamine, gabapentin and pregabalin for postoperative analgesia in pediatric
patients. Further studies to establish the clinical benefit and efficacy of
nonopioid analgesic agents in pediatric patients are needed.
