Çocuklarda Postoperatif Ağrı

Yıl 2022, , 220 - 224, 29.04.2022

Ümit Akkemik

https://doi.org/10.54005/geneltip.1007469

Öz

Postoperatif ağrı cerrahi travma ile başlayan ve dokunun iyileşmesi ile giderek azalan bir akut ağrıdır. Pediatrik popülasyonda ağrı algılama mekanizması farklıdır ve yeterince anlaşılmamıştır. Pediatrik hastalarda ağrının tanımlanması ve derecelendirmesindeki zorluklar tedaviyi de güçleştirir. Çocuklarda postoperatif ağrı yönetimi multidisipliner ve multimodel bir yaklaşım ile planlanmalıdır. Bu yazıda pediatrik postoperatif ağrı yönetimi hakkında güncel bilgilerin derlenmesi amaçlanmıştır.

Anahtar Kelimeler

postoperatif ağrı, ağrı tedavisi, çocuk

Postoperative Pain in Children

Öz

Postoperative pain is an acute pain that starts with surgical trauma and gradually decreases with healing of the tissue. The mechanism of pain perception in the pediatric population is different and poorly understood. Difficulties in defining and grading pain in pediatric patients also complicate treatment. Postoperative pain management in children should be planned with a multidisciplinary and multimodal approach. In this article, it is aimed to review up-to-date information on pediatric postoperative pain management.

Anahtar Kelimeler

postoperative pain, pain management, child

Kaynakça

• Raja SN, Carr DB, Cohen M, et al.: The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020, 161:1976-82.
• Wong C, Lau E, Palozzi L, Campbell F. Pain management in children: Part 1 - Pain assessment tools and a brief review of nonpharmacological and pharmacological treatment options. Can Pharm J (Ott). 2012 Sep;145(5):222-5.
• Mathews L. Pain in children: neglected, unaddressed and mismanaged. Indian J Palliat Care. 2011;17(Suppl):S70-S73.
• Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287-2298.
• Dmytriiev D. Assessment and treatment of postoperative pain in children. Anaesth Pain & Intensive Care 2018;22(3):392-400
• Bulloch B, Tenenbein M. Assessment of clinically significant changes in acute pain in children. Acad Emerg Med. 2002;9:199–202
• Kulshrestha A, Bajwa SJS. Management of acute postoperative pain in pediatric patients. Anaesth Pain & Intensive Care 2014;18(1):101-107
• Stevens BJ, Hathway G, Zempsky WT, Williams G, Howard RF. Postoperative pain management. In: Oxford Textbook of Pediatric Pain. 2 ed. Oxford, UK: Oxford University Press; 2021:282-291.
• Pawar D, Garten L, Kopf A, Pathel NB. Pain management in children. In: Guide to Pain Management in Low-Resource Settings. Int Assoc Study Pain. 2010:255–267.
• Zieliński J, Morawska-Kochman M, Zatoński T. Pain assessment and management in children in the postoperative period: A review of the most commonly used postoperative pain assessment tools, new diagnostic methods and the latest guidelines for postoperative pain therapy in children. Adv Clin Exp Med. 2020;29(3):365–374.
• Bentley J 2014 Anatomy and physiology of pain. In: Twycross A, Dowden S, Stinson J (Eds) Managing Pain in Children: A Clinical Guide for Nurses and Healthcare Professionals Chapter 2 Chichester, Wiley-Blackwell
• Baş SŞ. Postoperative Pain in Children. Turkiye Klinikleri J Anest Reanim-Special Topics. 2017;10(2):154-61
• Anderson BJ, van Lingen RA, Hansen TG, Lin YC, Holford NH. Acetaminophen developmental pharmacokinetics in premature neonates and infants: a pooled population analysis. Anesthesiology 2002;96:1336-345.
• Jahr JS, Lee VK: Intravenous acetaminophen. Anesthesiol Clin 2010;28;619-45.
• Heard K, Bui A, Mlynarchek SL, et al. Toxicity from repeated doses of acetaminophen in children: assessment of causality and dose in reported cases. Am J Ther. 2014;21(3):174-183.
• Lavonas EJ, Reynolds KM, Dart RC. Therapeutic acetaminophen is not associated with liver injury in children: a systematic review. Pediatrics 2010;126:e1430-44.
• Southey ER, Saores-Weiser K, Kleinen J. Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in pediatric pain and fever. Curr Med Res Opin 2009;25:2207- 222.
• Berde CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med 2002;347:1094-1103.
• Morton N, Arerra A 2009 APA national audit of paediatric opioid infusions Pediatric Anesthesia 20 (2) 119–125
• Verghese S, Hannallah R 2010 Acute pain management in children Journal of Pain Research 3 105–123
• Rosen DA, Dower J. Pediatric pain management. Pediatr Ann 2011;40(5):243-52
• Franson HE. Postoperative patient-controlled analgesia in the pediatric population: a literature review. AANA J 2010;78(5):374-8
• Kraemer FW, Rose JB. Pharmacologic management of acute pediatric pain. Anesthesiol Clin 2009;27(2):241-68.
• Taylor J, Liley A, Anderson BJ.The relationship between age and morphine infusion rate in children. Paediatr Anaesth 2013;23(1):40- 4.
• Walker SM. Pain after surgery in children: clinical recommendations. Curr Opin Anaesthesiol. 2015;28(5):570-6.
• Jöhr M. Regional anaesthesia in neonates, infants and children: an educational review. Eur J Anaesthesiol 2015; 32(5):289-97
• Visoiu M. Paediatric regional anaesthesia: a current perspective. Curr Opin Anaesthesiol 2015; 28(5):577-82.
• Cook B, Grubb DJ, Aldridge LA, et al. Comparison of the effects of adrenaline, clonidine and ketamine on the duration of caudal analgesia produced by bupivacaine in children. Br J Anaesth 1995; 75: 698-701
• Bennett M. Assessing pain in children in the perioperative setting. Journal of Perioperative Practice. 2019;29(1-2):9-16.
• Vittinghoff M, Lönnqvist PA, Mossetti V, et al. Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). Paediatr Anaesth. 2018;28(6):493-506.