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 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neuroscience(all)

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    Tubbs, R. S., Law, C., Davis, D., Mohajel Shoja, M., Acakpo-Satchivi, L., Wellons, J. C., Blount, J. P., & 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.