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

作者全名："Dai, Fangyu; Zhang, Rensen; Deng, Ruyu; Wang, Guoyong; Guo, Hongjie; Guo, Chunbao"

作者地址："[Dai, Fangyu; Zhang, Rensen; Wang, Guoyong] Chongqing Hlth Ctr Women & Children, Dept Pediat, Chongqing, Peoples R China; [Dai, Fangyu; Guo, Chunbao] Chongqing Med Univ, Anesthesiol Class 1, Chongqing, Peoples R China; [Dai, Fangyu; Zhang, Rensen; Wang, Guoyong] Chongqing Med Univ, Childrens Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China; [Zhang, Rensen; Guo, Hongjie] Chongqing Med Univ, Dept Anesthesiol, Childrens Hosp, Chongqing, Peoples R China; [Deng, Ruyu] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med,Minist Educ,Key Lab Child Dev & Diso, Chongqing, Peoples R China; [Guo, Chunbao] Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat, Chongqing, Peoples R China; [Guo, Chunbao] Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat Gen Surg, 120 Longshan Rd, Chongqing 401147, Peoples R China"

通信作者："Guo, CB (通讯作者)，Chongqing Med Univ, Anesthesiol Class 1, Chongqing, Peoples R China.; Guo, CB (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat, Chongqing, Peoples R China.; Guo, CB (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat Gen Surg, 120 Longshan Rd, Chongqing 401147, Peoples R China."

来源：BMC GASTROENTEROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001090754900002

JCR分区：Q2

影响因子：2.5

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Postoperative pain; Postoperative gastrointestinal tract dysfunction; Enhanced recovery after Surgery; Patient-controlled analgesia; Pediatrics; Meckel's diverticulum

摘要："BackgroundThe 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.MethodsPatients 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.ResultsIn 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).ConclusionsThe 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."

基金机构：We thank Dr. Siqi Yang for providing insightful discussions during the preparation of the manuscript and Dr. Xiaoyong Zhang at the Wistar Institute for help with the linguistic revision of the manuscript.

基金资助正文：We thank Dr. Siqi Yang for providing insightful discussions during the preparation of the manuscript and Dr. Xiaoyong Zhang at the Wistar Institute for help with the linguistic revision of the manuscript.