Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps
Objective: 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. Ma...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
|
| Series: | Annals of Pediatric Cardiology |
| Subjects: | |
| Online Access: | http://www.annalspc.com/article.asp?issn=0974-2069;year=2020;volume=13;issue=1;spage=46;epage=55;aulast=Saini |
| _version_ | 1818564468384202752 |
|---|---|
| author | Ashish Saini Kevin O Maher Shriprasad R Deshpande |
| author_facet | Ashish Saini Kevin O Maher Shriprasad R Deshpande |
| author_sort | Ashish Saini |
| collection | DOAJ |
| description | Objective: 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.
Materials and Methods: 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.
Results/Data Synthesis: 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.
Conclusion: 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. |
| first_indexed | 2024-12-14T01:29:21Z |
| format | Article |
| id | doaj.art-fc2fa9a56bfb41649258fbfb21cf4fa5 |
| institution | Directory Open Access Journal |
| issn | 0974-2069 |
| language | English |
| last_indexed | 2024-12-14T01:29:21Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Pediatric Cardiology |
| spelling | doaj.art-fc2fa9a56bfb41649258fbfb21cf4fa52022-12-21T23:22:06ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20692020-01-01131465510.4103/apc.APC_190_18Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gapsAshish SainiKevin O MaherShriprasad R DeshpandeObjective: 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. Materials and Methods: 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. Results/Data Synthesis: 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. Conclusion: 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.http://www.annalspc.com/article.asp?issn=0974-2069;year=2020;volume=13;issue=1;spage=46;epage=55;aulast=Sainianalgesiacardiac surgeryinfantsnonopioidnonsteroidal anti-inflammatory drugspediatricpostoperative care |
| spellingShingle | Ashish Saini Kevin O Maher Shriprasad R Deshpande Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps Annals of Pediatric Cardiology analgesia cardiac surgery infants nonopioid nonsteroidal anti-inflammatory drugs pediatric postoperative care |
| title | Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps |
| title_full | Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps |
| title_fullStr | Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps |
| title_full_unstemmed | Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps |
| title_short | Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps |
| title_sort | nonopioid analgesics for perioperative and cardiac surgery pain in children current evidence and knowledge gaps |
| topic | analgesia cardiac surgery infants nonopioid nonsteroidal anti-inflammatory drugs pediatric postoperative care |
| url | http://www.annalspc.com/article.asp?issn=0974-2069;year=2020;volume=13;issue=1;spage=46;epage=55;aulast=Saini |
| work_keys_str_mv | AT ashishsaini nonopioidanalgesicsforperioperativeandcardiacsurgerypaininchildrencurrentevidenceandknowledgegaps AT kevinomaher nonopioidanalgesicsforperioperativeandcardiacsurgerypaininchildrencurrentevidenceandknowledgegaps AT shriprasadrdeshpande nonopioidanalgesicsforperioperativeandcardiacsurgerypaininchildrencurrentevidenceandknowledgegaps |