Ambulatory Pain Management in the Pediatric Patient Population

Oliver, Jodi-Ann; Oliver, Lori-Ann; Aggarwal, Nitish; Baldev, Khushboo; Wood, Melanie G.; Makusha, Lovemore Peter; Vadivelu, Nalini; Lichtor, Lance

doi:10.1007/s11916-022-00999-y

Cited by 11 publications

(13 citation statements)

References 76 publications

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“…7 When used in conjunction with Tylenol, as in our patient, this constitutes multimodal anesthetic technique, an approach with proven benefit in ambulatory pediatric patients. 8 While there is a documented report of pain insensitivity in 4QDS 9 , our patient had previously demonstrated a response to painful stimuli in the setting of incarcerated inguinal hernia, which warranted the adoption of the regional anesthetic technique. The QL nerve block has demonstrated efficacy in multiple randomized control trials, presented by Zhao et al in a meta-analysis of 346 patients, especially when administered under general anesthesia and ultrasound guidance.…”

Section: Discussionmentioning

confidence: 70%

Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review

Lovell

Larkins

Pasli

et al. 2023

Preprint

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Section: Discussionmentioning

confidence: 70%

Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review

Lovell

Larkins

Pasli

et al. 2023

Preprint

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“…El objetivo principal de las técnicas no farmacológicas es disminuir el nivel de ansiedad perioperatoria [1], [17]. La influencia de la interacción entre la ansiedad de los padres y el dolor del niño está bien documentada.…”

Section: -Técnicas No Farmacológicasunclassified

“…En cada especialidad quirúrgica, existen también combinaciones de técnicas analgésicas que han demostrado ser las más efectivas. En el artículo de JA Oliver [1], recientemente publicado se recomienda lo siguiente:…”

Section: Coadyuvantesunclassified

“…La cirugía ambulatoria ha aumentado de manera importante durante las últimas décadas. La literatura refiere que más del 75% de los niños tiene dolor en el período posoperatorio, cuando ya han sido dados de alta a sus casas, y de estos, el 40% tienen dolor moderado a severo [1], [2], [3]. Los cuidadores recurren al cirujano o al pediatra de cabecera, donde no existe un especialista en manejo de dolor.…”

unclassified

“…El objetivo principal es resaltar la importancia del manejo analgésico efectivo y seguro. El manejo multimodal del dolor es la estrategia más adecuada involucrando técnicas no farmacológicas, farmacológicas y técnicas de anestesia regional [1], [2], [3], [4], [6]. La selección de pacientes, planificación precoz de la estrategia analgesica y educación de los cuidadores son las claves para el éxito [9].…”

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Estrategias analgésicas para cirugía ambulatoria en niños

2021

Rev. chil. anest.

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During the last decades, there has been a significant growth in ambulatory surgeries. Literature, unfortunately, tells us that more than 75% of children have pain during the postoperative period, when they have been discharged, and 40% of these children have mild to severe pain. Caregivers turn to the surgeon, pediatrician or the clinic, places where usually there is no pain management specialist. Frequently, even when pain is evident, children get inadequate treatment. It is inadequate to say that children don't remember or don't respond to a painful experience at the same level as adults do. Many of the transmission and perception nerve tracts are developed in early life, being present and in function since week 24 of intrauterine gestation. The mistreated pain has immediate and long-term consequences. For clinicians, it is of utmost importance the knowledge of these consequences, summarizing, lifestyle deterioration, extended usage of (analgesics) painkillers and onset of persistent or chronic pain. Toddlers are not able to describe their pain or their subjective experience, due to this, the caregiver must learn how to evaluate properly. This evaluation is intended for every pediatric patient who meets the criteria for an ambulatory surgery. The main objective is to highlight the importance of a safe and effective analgesic management. The most appropriate method to treat postoperative severe pain is multimodal, which involves nonpharmacological, pharmacological, and local anesthetic techniques. The patients' selection, the early anesthetic strategy planning and caregivers' education are the keys for success.

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Airway management and quadratus lumborum block for inguinal hernia repair in context of chromosome 4q deletion: A case report

Lovell,

Larkins,

Pasli

et al. 2023

Clinical Case Reports

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Key Clinical MessageChromosome 4q Deletion Syndrome (4QDS) is a rare chromosomal deletion that presents with various congenital defects that could affect anesthetic management. We present a patient with known 4QDS who underwent successful general anesthetic induction, tracheal intubation, and subsequently, bilateral quadratus lumborum nerve blocks, during laparoscopic inguinal hernia repair surgery.AbstractChromosome 4q deletion syndrome (4QDS) is a rare chromosomal deletion with the potential for congenital defects that could affect the anesthetic management of affected patients, specifically with inconsistent reports of possible laryngeal narrowing which could precipitate intubation difficulties. We present a report of a patient with known 4QDS who underwent successful general anesthetic induction and tracheal intubation, followed by subsequent bilateral quadratus lumborum nerve blocks, in the context of laparoscopic inguinal hernia repair surgery. Given the inconsistent presentation of patients with 4QDS reported in the literature, steps were taken to exercise sufficient caution concerning the overall management of this patient per the most recent guidelines for pediatric patients.

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Ambulatory Pain Management in the Pediatric Patient Population

Cited by 11 publications

References 76 publications

Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review

Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review

Estrategias analgésicas para cirugía ambulatoria en niños

Airway management and quadratus lumborum block for inguinal hernia repair in context of chromosome 4q deletion: A case report

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