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Postoperative analgesia in infants and children.
MedLine Citation:
PMID:  17021476     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Although postoperative analgesia in infants and children should be an integral part of the perioperative management, undertreatment of pain is not rare in clinical practice and may influence outcome and long term behaviour. Therefore, this review summarizes results of recent papers and discusses actual trends and future perspectives concerning postoperative pharmacologic pain therapy in infants and children. RECENT FINDINGS: A multimodal approach using locoregional anesthesia and systemic analgesics is a widely accepted technique. New developments include new local anesthetics with a wider margin of safety and more experience with adjuvants, catheter techniques and systemic analgesics. Replacement of bupivacaine with ropivacaine may be prudent especially for prolonged epidural infusion, use in neonates, impaired hepatic metabolic function, and anesthetic techniques requiring large dosage of local anesthetic. The limited duration of analgesia after single blocks can be prolonged by use of adjuvants (clonidine, ketamine), catheter techniques or early use of systemic analgesics. Non-opioids (acetaminophen, non-steroidal anti-inflammatory drugs) are appropriate for patients with mild to moderate pain or as a component of multimodal pain therapy. Patient- and nurse-controlled analgesia are convenient ways for opioid administration in infants and children. SUMMARY: The reviewed studies suggest that there are many reliable agents and techniques available to provide a safe and effective postoperative analgesia even in neonates and small infants.
Authors:
Robert Sümpelmann; Sinikka Münte
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  16     ISSN:  0952-7907     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2006-10-05     Completed Date:  2007-06-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-13     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, Medical Highschool Hannover, Hannover, Germany. suempelmann.robert@mh-hannover.de
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