Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy

R. Shane Tubbs, Charles Law, Drew Davis, Mohammadali Mohajel Shoja, Leslie Acakpo-Satchivi, John C. Wellons, Jeffrey P. Blount, W. Jerry Oakes

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Object. Postoperative epidural morphine is commonly used to control pain in children following dorsal rhizotomy for spasticity. The authors report their experience in using a regimen of scheduled minor analgesic drugs to manage postoperative pain, with the goal of avoiding opiate use following a spinal intradural procedure. Methods. Postoperative pain scores were analyzed in a group of 22 children who underwent a partial dorsal rhizotomy. According to a preestablished standard regimen for postoperative pain control after dorsal rhizotomy, in each patient an intraoperative epidural catheter was placed for the potential infusion of postoperative morphine. Additionally, this cohort underwent a scheduled regimen of acetaminophen (10 mg/kg) and ibuprofen (10 mg/kg), alternating every 2 hours. For comparison, a retrospective chart review was performed in 20 patients with rhizotomies completed prior to the use of this oral analgesic protocol. Only one patient received a postoperative dose of morphine epidurally. None of the remaining patients required postoperative epidural morphine for pain control. Pain scores were significantly lower in this group compared with a retrospective review of patients treated according to the standard regimen. Length of hospital stay was shorter in these patients and antiemetic requirements were lower. Conclusions. A regimen of minor analgesic therapy, when given in alternating doses every 2 hours immediately after partial dorsal rhizotomy for spasticity and throughout hospitalization, significantly reduced postoperative pain scores, hospitalization, and antiemetic requirements in these patients.

Original languageEnglish (US)
Pages (from-to)439-440
Number of pages2
JournalJournal of Neurosurgery
Volume106
Issue number6 SUPPL.
StatePublished - Jun 1 2007
Externally publishedYes

Fingerprint

Opiate Alkaloids
Rhizotomy
Analgesics
Postoperative Pain
Morphine
Antiemetics
Pain
Length of Stay
Hospitalization
Ibuprofen
Acetaminophen
Catheters

Keywords

  • Dorsal rhizotomy
  • Pain control
  • Pediatric neurosurgery
  • Spinal cord

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neuroscience(all)

Cite this

Tubbs, R. S., Law, C., Davis, D., Mohajel Shoja, M., Acakpo-Satchivi, L., Wellons, J. C., ... Oakes, W. J. (2007). Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy. Journal of Neurosurgery, 106(6 SUPPL.), 439-440.

Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy. / Tubbs, R. Shane; Law, Charles; Davis, Drew; Mohajel Shoja, Mohammadali; Acakpo-Satchivi, Leslie; Wellons, John C.; Blount, Jeffrey P.; Oakes, W. Jerry.

In: Journal of Neurosurgery, Vol. 106, No. 6 SUPPL., 01.06.2007, p. 439-440.

Research output: Contribution to journalArticle

Tubbs, RS, Law, C, Davis, D, Mohajel Shoja, M, Acakpo-Satchivi, L, Wellons, JC, Blount, JP & Oakes, WJ 2007, 'Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy', Journal of Neurosurgery, vol. 106, no. 6 SUPPL., pp. 439-440.
Tubbs RS, Law C, Davis D, Mohajel Shoja M, Acakpo-Satchivi L, Wellons JC et al. Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy. Journal of Neurosurgery. 2007 Jun 1;106(6 SUPPL.):439-440.
Tubbs, R. Shane ; Law, Charles ; Davis, Drew ; Mohajel Shoja, Mohammadali ; Acakpo-Satchivi, Leslie ; Wellons, John C. ; Blount, Jeffrey P. ; Oakes, W. Jerry. / Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy. In: Journal of Neurosurgery. 2007 ; Vol. 106, No. 6 SUPPL. pp. 439-440.
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