Analgesic Patterns and Opioid Administration in Children Hospitalized With Acute Pancreatitis.
Analgesic Patterns and Opioid Administration in Children Hospitalized With Acute Pancreatitis.
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DOI：
10.1097/mpg.0000000000003771
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发表时间：
2023-06-01
影响因子：
2.9
通讯作者：
Palermo, Tonya M.
中科院分区：
文献类型：
--
作者：
Gorbounova, Irina;Tham, See Wan;Abu-El-Haija, Maisam;Palermo, Tonya M.
疼痛是急性胰腺炎（AP）最常见的症状，阿片类药物已被用作治疗的基石。尽管阿片类药物有不良反应，但缺乏关于AP患儿有效镇痛的数据。我们的目的是评估儿科AP的镇痛处方模式，确定与阿片类药物给药相关的因素，并测试阿片类药物给药与住院时间（LOS）之间的关系。这是一项2010年至2020年单一机构儿科AP住院的回顾性队列研究。计算入院前48小时的阿片类药物给药（吗啡毫克当量；MME48）。收集住院期间多模式镇痛（定义为给药扑热息痛和非甾体抗炎药）的数据。样本包括224例患者，平均年龄12.0岁（SD=4.9）， 58.9%为女性。平均生存时间为4天（IQR 2-9）。大多数患者（71.4%）使用阿片类药物，77.7%使用对乙酰氨基酚，40.2%使用非甾体抗炎药，37.5%使用多模式镇痛药。阿片类药物的使用在研究期间有所减少；相反，多模式镇痛给药增加。阿片类药物给药没有性别、年龄、胆道与非胆道病因或种族/民族的差异。在多元回归模型中，较低的白蛋白值（p< 0.01）和较年轻的年龄（p< 0.05）是LOS增加的显著预测因子，而MME48与LOS增加无关。阿片类药物被普遍使用；只有37.5%的儿童在因AP住院期间接受了多模式镇痛。阿片类药物的使用与LOS增加无关。需要前瞻性研究来确定儿科AP的最佳疼痛管理。
Pain is the most common symptom of acute pancreatitis (AP), and opioids have been utilized as the cornerstone of treatment. Despite the adverse effects of opioids, data on effective analgesia in children with AP is lacking. We aimed to evaluate analgesia prescribing patterns in pediatric AP, identify factors associated with opioid administration, and test the associations between opioid administration and hospital length of stay (LOS). This is a retrospective cohort study of pediatric AP hospitalizations in a single institution from 2010 to 2020. Opioid administration was calculated for the first 48 hours of admission (morphine milligram equivalent; MME48). Data on multimodal analgesia (defined as the administration of acetaminophen and nonsteroidal anti-inflammatory drugs) during hospitalization was captured. The sample included 224 patients, mean age 12.0 years (SD=4.9) and 58.9% female. Median LOS was 4 days (IQR 2–9). Most patients (71.4%) were prescribed opioids, 77.7% acetaminophen, 40.2% NSAIDs and 37.5% multimodal analgesia. Opioid administration decreased over the study period; in contrast, there was an increase in multimodal analgesia administration. Opioid administration did not differ by sex, age, biliary vs non-biliary etiology, or race/ethnicity. In a multivariate regression model, lower albumin values (p<.01) and younger age (p<.05) were significant predictors of increased LOS, while MME48 was not associated with increased LOS. Opioids were commonly administered; only 37.5% of children were administered multimodal analgesia during their hospitalization for AP. Opioid administration was not associated with increased LOS. Prospective studies are needed to determine optimal pain management for pediatric AP.
对儿科中简单的急性镰状细胞疼痛危机的镇痛治疗：系统评价和荟萃分析。
影响因子：
3.3
作者：
Saramba, Manou Irmina;Shakya, Sandeep;Zhao, Dongchi
通讯作者：
Zhao, Dongchi