دورية أكاديمية
Multisite prospective study of perioperative pain management practices for anterior cruciate ligament reconstruction in adolescents: Society for Pediatric Anesthesia Improvement Network (SPAIN) Project Report.
| العنوان: | Multisite prospective study of perioperative pain management practices for anterior cruciate ligament reconstruction in adolescents: Society for Pediatric Anesthesia Improvement Network (SPAIN) Project Report. |
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| المؤلفون: | Sadacharam K; Nemours Children's Hospital Delaware, Wilmington, Delaware, USA kesavan2654@gmail.com., Furstein JS; Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Staffa SJ; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA., Li G; Nemours Children's Health System, Jacksonville, Florida, USA., Karroum R; Department of Anesthesiology and Pain Medicine, Akron Children's Hospital, Akron, Ohio, USA., Booth JM; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA., Kim E; Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Los Angeles, California, USA., McCahan SM; Nemours Children's Hospital Delaware, Wilmington, Delaware, USA., Muhly WT; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Chidambaran V; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. |
| مؤلفون مشاركون: | SPAIN-ACL Investigators |
| المصدر: | Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2024 Apr 18. Date of Electronic Publication: 2024 Apr 18. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Country of Publication: England NLM ID: 9804508 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8651 (Electronic) Linking ISSN: 10987339 NLM ISO Abbreviation: Reg Anesth Pain Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [London, United Kingdom] : BMJ Original Publication: Secaucus, NJ : Churchill Livingstone, c1998- |
| مستخلص: | Introduction: Although 200 000 adolescents undergo anterior cruciate ligament reconstruction (ACLR) surgery annually, no benchmarks for pediatric post-ACLR pain management exist. We created a multicenter, prospective, observational registry to describe pain practices, pain, and functional recovery after pediatric ACLR. Methods: Participants (n=519; 12-17.5 years) were enrolled from 15 sites over 2 years. Data on perioperative management and surgical factors were collected. Pain/opioid use and Lysholm scores were assessed preoperatively, on postoperative day 1 (POD1), POD3, week 6, and month 6. Descriptive statistics and trends for opioid use, pain, and function are presented. Results: Regional analgesia was performed in 447/519 (86%) subjects; of these, adductor canal single shot was most frequent (54%), nerve catheters placed in 24%, and perineural adjuvants used in 43%. On POD1, POD3, week 6, and month 6, survey response rates were 73%, 71%, 61%, and 45%, respectively. Over these respective time points, pain score >3/10 was reported by 64% (95% CI: 59% to 69%), 46% (95% CI: 41% to 52%), 5% (95% CI: 3% to 8%), and 3% (95% CI: 1% to 6%); the number of daily oxycodone doses used was 2.8 (SD 0.19), 1.8 (SD 0.13), 0, and 0. There was considerable variability in timing and tests for postdischarge functional assessments. Numbness and weakness were reported by 11% and 4% at week 6 (n=315) and 16% and 2% at month 6 (n=233), respectively. Conclusion: We found substantial variability in the use of blocks to manage post-ACLR pain in children, with a small percentage experiencing long-term pain and neurological symptoms. Studies are needed to determine best practices for regional anesthesia and functional assessments in this patient population. Competing Interests: Competing interests: None declared. (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| فهرسة مساهمة: | Investigator: JP Cravero; J Bradley; M Ellington; T Mandler; B Taicher; MB Welch; A Fernandez; GK Ungar; C Fuller; S Kelleher; M Milewski; C Bannister; RS Lang; C Glover; B Zelisko; T Bhalla; MC Mitchell; P Befanti; D Warnick; K Householder; M Masarrachia; B Ohlendorf; B Lau; L Einhorn Keywords: Analgesics, Opioid; Lower Extremity; Pain, Postoperative; Pediatrics |
| تواريخ الأحداث: | Date Created: 20240418 Latest Revision: 20240418 |
| رمز التحديث: | 20240419 |
| DOI: | 10.1136/rapm-2024-105381 |
| PMID: | 38637132 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1532-8651 |
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| DOI: | 10.1136/rapm-2024-105381 |