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Strategies for preventing side effects of systemic opioid in postoperative pediatric patients
Author(s) -
Jitpakdee Thanaporn,
Mandee Sahatsa
Publication year - 2014
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12420
Subject(s) - medicine , opioid , adverse effect , anesthesia , vomiting , placebo , side effect (computer science) , nausea , randomized controlled trial , surgery , alternative medicine , receptor , pathology , computer science , programming language
Summary Background and Objectives Opioid is the gold standard for treating moderate‐to‐severe pain in pediatric patients. However, its undesirable side effects lead to unsatisfied postoperative pain management outcome (Pediatr Anesth, 17, 2007, 756). The most commonly reported opioid‐related side effects are vomiting (40%), pruritus (20–60%) (Anesthesiology, 77, 1992, 162; Drugs, 67, 2007, 2323), and constipation (15–90%) (Int J Clin Pract, 61, 2007, 1181). The potential life‐threatening adverse event, respiratory depression, is less common (0.0013%) (Pediatr Anesth, 20, 2010, 119). The aim of this review was to evaluate prevention strategies that have been shown to decrease opioid side effects in pediatric patients during the postoperative period. Methods Literature searches were conducted from 1984 to February 2013. Meta‐analysis, systematic review, and randomized, placebo‐controlled studies were obtained from PubMed and the Cochrane Library. The medical subject heading (Me SH ) terms were opioid analgesics, adverse effects, pediatrics, children, side effects, and postoperative pain. Results and conclusion Data from 62 studies were reviewed. The strategies that could effectively prevent and reduce opioid side effects in pediatric patients during the postoperative period included minimizing the amount of opioid consumption by a multimodal approach, opioid titration, using local anesthetic techniques and providing the specific prophylaxis for each side effect.