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 language | English (US) |
|---|---|
| Pages (from-to) | 439-440 |
| Number of pages | 2 |
| Journal | Journal of Neurosurgery |
| Volume | 106 |
| Issue number | 6 SUPPL. |
| State | Published - Jun 1 2007 |
| Externally published | Yes |
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Keywords
- Dorsal rhizotomy
- Pain control
- Pediatric neurosurgery
- Spinal cord
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Neuroscience(all)
Cite this
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 journal › Article
}
TY - JOUR
T1 - Scheduled oral analgesics and the need for opiates in children following partial dorsal rhizotomy
AU - Tubbs, R. Shane
AU - Law, Charles
AU - Davis, Drew
AU - Mohajel Shoja, Mohammadali
AU - Acakpo-Satchivi, Leslie
AU - Wellons, John C.
AU - Blount, Jeffrey P.
AU - Oakes, W. Jerry
PY - 2007/6/1
Y1 - 2007/6/1
N2 - 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.
AB - 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.
KW - Dorsal rhizotomy
KW - Pain control
KW - Pediatric neurosurgery
KW - Spinal cord
UR - http://www.scopus.com/inward/record.url?scp=34250834519&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34250834519&partnerID=8YFLogxK
M3 - Article
C2 - 17566399
AN - SCOPUS:34250834519
VL - 106
SP - 439
EP - 440
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 6 SUPPL.
ER -