The Effect of Pre-Emptive Analgesia on the Postoperative Pain in Pediatric Otolaryngology: A Randomized, Controlled Trial

Zieliński, Jakub; Morawska-Kochman, Monika; Dudek, Krzysztof; Czapla, Michał; Zatoński, Tomasz

doi:10.3390/jcm11102713

Cited by 4 publications

(2 citation statements)

References 43 publications

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“…New developments in ENT surgeries include pre-emptive analgesia, non-opioid analgesics, and nerve stimulation therapy. A randomized controlled trial demonstrated that pre-emptive analgesia using nalbuphine and dexamethasone effectively decreased postoperative pain in pediatric otolaryngology patients [ 36 ]. Non-opioid analgesics, like NSAIDs, have exhibited the capacity to reduce postoperative vomiting and manage pain comparably to opioids [ 36 ].…”

Section: Reviewmentioning

confidence: 99%

“…A randomized controlled trial demonstrated that pre-emptive analgesia using nalbuphine and dexamethasone effectively decreased postoperative pain in pediatric otolaryngology patients [ 36 ]. Non-opioid analgesics, like NSAIDs, have exhibited the capacity to reduce postoperative vomiting and manage pain comparably to opioids [ 36 ]. Hypoglossal nerve stimulation therapy, also recognized as upper airway stimulation, emerges as a promising treatment for obstructive sleep apnea [ 37 ].…”

Section: Reviewmentioning

confidence: 99%

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Nalbuphine’s Hemodynamic Impact in Ear, Nose, and Throat (ENT) Surgeries: A Comprehensive Review

Shah,

Sen

2024

Cureus

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Nalbuphine, a semi-synthetic opioid, has gained attention for its analgesic properties, but its specific impact on hemodynamics in ear, nose, and throat (ENT) surgeries remains a subject of exploration. This comprehensive review aims to systematically analyze existing literature to understand the nuanced hemodynamic effects of nalbuphine during ENT procedures. Nalbuphine demonstrates promise as an analgesic agent in ENT surgeries with generally stable hemodynamic profiles. However, the variability in study designs and outcomes necessitates a cautious interpretation. The review underscores the need for standardized protocols and further research to elucidate patient-specific considerations, ensuring optimal utilization of nalbuphine in enhancing overall perioperative care for ENT patients.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Nalbuphine’s Hemodynamic Impact in Ear, Nose, and Throat (ENT) Surgeries: A Comprehensive Review

Shah,

Sen

2024

Cureus

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Severity and associated factors of postoperative pain in paediatric surgical patients aged 2 months–7 years at selected Addis Ababa Public Hospitals: a multicenter prospective longitudinal study

Rede,

Goshu,

muzien

2024

Annals of Medicine &Amp; Surgery

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Background: Postoperative pain is a common and distressing consequence of surgery in children. It can lead to suffering, prolonged recovery, impaired physical functioning, and even chronic pain. Effective postoperative pain management is crucial for improving patient outcomes. However, several factors hinder the accurate assessment and management of pain in children, particularly in low-income countries. This study aims to evaluate the severity of postoperative pain in pediatric patients and identify its predictors. Materials and Methods: A longitudinal study was conducted on 235 pediatric surgical patients aged 2 months to 7 years in Public Hospitals of Addis Ababa from January to April 2023. The primary outcome, pain severity, was assessed at three different times using a pain assessment tool. Cochran’s q test was used to compare postoperative pain incidences. The Generalized Estimating Equation was used to determine predictor variables’ effects on pain severity over time. The study demonstrated the direction of association and significance using an AOR with a 95% CI at a P value of 0.05. Result: the incidence of moderate to severe postoperative pain was 36.6% at 12 hours, 20% at 24 hours, and 10% at 36 hours. Patients with preoperative pain and preoperative anxiety were more likely to experience moderate to severe postoperative pain (AOR=3.41, CI=1.15,10.00 and AOR=2.28, CI=1.219,4.277, respectively). Intraoperative predictors of postoperative pain severity included longer duration of surgery (AOR=6.62, CI=1.90,23.00) and major surgery (AOR=5.2, CI=2.11,12.88). Postoperative pain severity was reduced in patients receiving multimodal analgesia (AOR=0.24; CI=0.091, 0.652) and in patients assessed frequently in the postoperative period (AOR=0.09; CI=0.022, 0.393). Conclusion: A significant portion of pediatric surgical patients in this study experienced high levels of postoperative pain, particularly within the first 24 hours. The most influential factors affecting pain severity were postoperative pain management strategies and assessment practices.

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Adenotonsillektomi ve Tonsillektomi operasyonlarında preemptif analjezinin derlenme deliryumu üzerine etkisi

Olgun Keles,

Tekir Yılmaz

2024

Turkish Journal of Clinics and Laboratory

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ABSTRACT Objective: Emergency delirium is a phenomenon of unknown etiology, mostly seen in young children, characterised by aggressive behaviour, lack of eye contact and lack of awareness of the environment. It has been shown to have many causes, but head and neck surgery, inhaled agents and post-operative pain are the most common. The PAED scale is the most sensitive scale and a score of 10 or more indicates immediate delirium. Pre-emptive analgesia is the interruption of pain pathways before the painful stimulus occurs, and its effectiveness in post-operative analgesia has been confirmed by many studies. This study was designed with the hypothesis that post-operative pain reduced by pre-emptive analgesia would reduce emergency delirium. Materials and methods: After ethics committee approval, 96 ASAI-II patients aged 2-7 years undergoing adenotonsillectomy and tonsillectomy were randomised into two groups. Analgesics were administered to the pre-emptive group before induction and to the intra-operative group 15 min after the start of surgery. In the recovery room, ED was assessed using the PAED scale and pain scores were assessed using the FLACC scores. PAED>10 was considered recovery delirium. The primary outcome was the incidence of recovery delirium. Secondary outcomes were delirium and pain scores. Results: PAED and FLACC scores were significantly lower in the preemptive group. There was a significant difference in the incidence of ED between the two groups only at 5 minutes. Conclusions: In children undergoing adenotonsillectomy and tonsillectomy, preemptive analgesia reduced postoperative pain scores and delirium scores, but did not reduce the incidence of recovery delirium.

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The Effect of Pre-Emptive Analgesia on the Postoperative Pain in Pediatric Otolaryngology: A Randomized, Controlled Trial

Cited by 4 publications

References 43 publications

Nalbuphine’s Hemodynamic Impact in Ear, Nose, and Throat (ENT) Surgeries: A Comprehensive Review

Nalbuphine’s Hemodynamic Impact in Ear, Nose, and Throat (ENT) Surgeries: A Comprehensive Review

Severity and associated factors of postoperative pain in paediatric surgical patients aged 2 months–7 years at selected Addis Ababa Public Hospitals: a multicenter prospective longitudinal study

Adenotonsillektomi ve Tonsillektomi operasyonlarında preemptif analjezinin derlenme deliryumu üzerine etkisi

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