Regular use of low-dose of opioids after gastrointestinal surgery may lead to postoperative gastrointestinal tract dysfunction in children: a Chinese national regional health center experience sharing

BMC Gastroenterology - Tập 23 - Trang 1-7 - 2023
Fangyu Dai1,2,3, Rensen Zhang1,3,4, Ruyu Deng5, Guoyong Wang1,3, Hongjie Guo4, Chunbao Guo2,6,7
1Department of Pediatrics, Chongqing health center for women and children, Chongqing, P.R. China
2Anesthesiology Class 1, Chongqing Medical University, Chongqing, P.R. China
3Department of Pediatric General Surgery, Children’s Hospital, Chongqing Medical University, Chongqing, P.R. China
4Department of Anesthesiology, Children’s Hospital of Chongqing Medical University, Chongqing, P.R. China
5Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, P.R. China
6Department of Pediatrics, Women and Children’s Hospital of Chongqing Medical University, Chongqing, P.R. China
7Department of Pediatric General Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, Chongqing, P.R. China

Tóm tắt

The need for pain management is increasing in pediatrics, but the side effects of overuse or abuse of analgesics can be harmful to children’s health and even life-threatening in severe cases. Patients who underwent resection of Meckel’s diverticulum at the Children’s Hospital of Chongqing Medical University from July 1, 2019, to July 1, 2022, were included in this study. Opioids were administered through patient-controlled analgesia (PCA). Based on the preoperative choices made by the legal guardians, patients were stratified into two groups: PCA Group (PCAG) and Non-PCA Group (NPCAG). Data pertaining to the clinical characteristics and prognoses of these patients were subsequently collected and analyzed to assess the impact of opioid administration. In the study, a total of 126 patients were enrolled, with 72 allocated to the Patient-Controlled Analgesia Group (PCAG) and 54 to the Non-Patient-Controlled Analgesia Group (NPCAG). When compared to the NPCAG, the PCAG exhibited a longer duration of postoperative fasting (median 72 vs. 62 h, p = 0.044) and increased utilization of laxatives (12[16.7%] vs. 2[3.7%], p = 0.022). However, the PCAG also experienced higher incidences of intestinal stasis and abnormal intestinal dilation (13[18.1%] vs. 3[5.6%], p = 0.037). No statistically significant differences were observed in pain assessments at the conclusion of the surgical procedure (0 vs. 1[1.9%], p = 0.429) or within the first 24 h postoperatively (16[22.2%] vs. 18[33.3%], p = 0.164). Additionally, NPCAG patients did not necessitate increased administration of rescue analgesics (2[2.8%] vs. 4[7.4%], p = 0.432). The administration of opioids did not demonstrably ameliorate postoperative pain but was associated with a heightened incidence of postoperative gastrointestinal tract dysfunction. The retrospective nature of the current research should be considered and should be clarified further.

Tài liệu tham khảo

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