Postoperative pain in children

May 17, 2008

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NEW YORK (Reuters Health) write - Postoperative pain in children with cancer can be safely managed with simultaneous epidural and intravenous opioids, according to researchers at St. Jude Children’s Research Hospital in Memphis, Tennessee.

Anghelescu D.L., Ross C.E., Oakes L.L. and Burgoyne L.L. (2008) The Safety of Concurrent Administration of Opioids via Epidural and Intravenous Routes for Postoperative Pain in Pediatric Oncology Patients. Journal of pain and symptom management. 35(4), p.412-419.

Abstract

“Supplementation of epidural opioid analgesia with intravenous opioids is usually avoided because of concern about respiratory depression. However, the choice of adjunct analgesic agents for pediatric oncology patients is limited. Antipyretic drugs may mask fever in neutropenic patients, and nonsteroidal anti-inflammatory agents may exert antiplatelet effects and interact with chemotherapeutic agents. We examined the safety of concurrent use of epidural and intravenous opioids in a consecutive series of 117 epidural infusions in pediatric patients and compared our findings to those reported by other investigators. We observed a 0.85% rate of clinically significant respiratory complications. The single adverse event was associated with an error in dosage. In our experience, the supplementation of epidural opioid analgesia with intravenous opioids has been a safe method of postoperative pain control for pediatric patients with cancer” (Anghelescu et al 2008).