Postoperative Pain Intensity in Pediatric Patients Following Orthopedic Extremity Surgery and the Effectiveness of Anesthetic Techniques at a Tertiary University Hospital
Keywords:
extremity surgery, orthopedic, pain management, postoperative pain, pediatricAbstract
Pain Management in Pediatrics is particularly challenging due to the vulnerability of patients and the need for specific considerations when administering analgesic medications, which can lead to inadequate pain management for some patients. As a tertiary university hospital, we care for many pediatric patients undergoing orthopedic extremity surgeries and have employed various methods for postoperative pain control. Therefore, this study aimed to evaluate postoperative pain and the effectiveness of anesthetic techniques in managing pain for this patient group. A retrospective descriptive study was conducted on pediatric patients who underwent orthopedic surgeries between October 2020 and September 2021. The study data included pain intensity at rest and during movement, fentanyl usage, and postoperative pain outcomes for each anesthetic technique. Descriptive statistics and a generalized linear model were used for statistical analysis. During the study period, 143 patients underwent orthopedic extremity surgery, with the majority being boys (62.2%) and an average age of 7 years. Most surgeries were on the lower extremities (84.6%), and the majority of patients received general anesthesia (GA) alone (55.9%). In the post-anesthetic care unit (PACU), over half of the patients reported mild or no pain at rest and during movement (52.4% and 50.3%, respectively), with a gradual decrease in pain on days 1 and 2. Compared to those who received GA alone, patients who received spinal block (SB) or combined regional anesthesia (RA) with GA experienced less pain at rest and during movement in the PACU, as well as a reduced need for fentanyl during both the intraoperative and postoperative periods. In conclusion, the regional anesthesia techniques, such as spinal block alone or in combination with general anesthesia, are effective in controlling postoperative acute pain and reducing opioid usage in pediatric patients undergoing orthopedic extremity surgeries.
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