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[PMID]: | 29049110 |
[Au] Autor: | Zhu A; Benzon HA; Anderson TA |
[Ad] Endereço: | From the *Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; and †Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois. |
[Ti] Título: | Evidence for the Efficacy of Systemic Opioid-Sparing Analgesics in Pediatric Surgical Populations: A Systematic Review. |
[So] Source: | Anesth Analg;125(5):1569-1587, 2017 Nov. | [Is] ISSN: | 1526-7598 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative analgesia in pediatric surgical populations. A comprehensive literature search identified meta-analyses and randomized controlled trials (RCTs) assessing the effects of systemic, nonopioid agents on postoperative narcotic requirements or pain scores in pediatric surgical populations. If a meta-analysis was located, we summarized its results and any RCTs published after it. We located and reviewed 11 acetaminophen RCTs, 1 nonsteroidal anti-inflammatory drug (NSAID) meta-analysis, 2 NSAID RCTs, 1 dexamethasone meta-analysis, 3 dexamethasone RCTs, 2 ketamine meta-analyses, 5 ketamine RCTs, 2 gabapentin RCTs, 1 clonidine meta-analysis, 3 magnesium RCTs, 2 dexmedetomidine meta-analyses, and 1 dextromethorphan RCT. No meta-analyses or RCTs were found assessing the perioperative efficacy of intravenous lidocaine, amantadine, pregabalin, esmolol, or caffeine in pediatric surgical patients. The available evidence is limited, but suggests that perioperative acetaminophen, NSAIDs, dexamethasone, ketamine, clonidine, and dexmedetomidine may decrease postoperative pain and opioid consumption in some pediatric surgical populations. Not enough, or no, data exist from which to draw conclusions on the perioperative use of gabapentin, magnesium, dextromethorphan, lidocaine, amantadine, pregabalin, esmolol, and caffeine in pediatric surgical patients. Further pharmacokinetic and pharmacodynamics studies to establish both the clinical benefit and efficacy of nonopioid analgesia in pediatric populations are needed. |
[Mh] Termos MeSH primário: |
Analgésicos Opioides/administração & dosagem Analgésicos/administração & dosagem Dor Pós-Operatória/prevenção & controle
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[Mh] Termos MeSH secundário: |
Adolescente Fatores Etários Analgésicos/efeitos adversos Analgésicos Opioides/efeitos adversos Criança Pré-Escolar Esquema de Medicação Cálculos da Dosagem de Medicamento Medicina Baseada em Evidências Seres Humanos Lactente Recém-Nascido Metanálise como Assunto Medição da Dor Dor Pós-Operatória/diagnóstico Dor Pós-Operatória/etiologia Ensaios Clínicos Controlados Aleatórios como Assunto Resultado do Tratamento
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; REVIEW |
[Nm] Nome de substância:
| 0 (Analgesics); 0 (Analgesics, Opioid) |
[Em] Mês de entrada: | 1710 |
[Cu] Atualização por classe: | 171030 |
[Lr] Data última revisão:
| 171030 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 171020 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1213/ANE.0000000000002434 |
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