Cravero Joseph P, Agarwal Rita, Berde Charles, Birmingham Patrick, Coté Charles J, Galinkin Jeffrey, Isaac Lisa, Kost-Byerly Sabine, Krodel David, Maxwell Lynne, Voepel-Lewis Terri, Sethna Navil, Wilder Robert
Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Pediatric Anesthesiology Department, Lucille Packard Children's Hospital, Stanford University Medical School, Stanford, California.
Paediatr Anaesth. 2019 Jun;29(6):547-571. doi: 10.1111/pan.13639. Epub 2019 Jun 11.
Opioids have long held a prominent role in the management of perioperative pain in adults and children. Published reports concerning the appropriate, and inappropriate, use of these medications in pediatric patients have appeared in various publications over the last 50 years. For this document, the Society for Pediatric Anesthesia appointed a taskforce to evaluate the available literature and formulate recommendations with respect to the most salient aspects of perioperative opioid administration in children. The recommendations are graded based on the strength of the available evidence, with consensus of the experts applied for those issues where evidence is not available. The goal of the recommendations was to address the most important issues concerning opioid administration to children after surgery, including appropriate assessment of pain, monitoring of patients on opioid therapy, opioid dosing considerations, side effects of opioid treatment, strategies for opioid delivery, and assessment of analgesic efficacy. Regular updates are planned with a re-release of guidelines every 2 years.
阿片类药物长期以来在成人和儿童围手术期疼痛管理中占据重要地位。在过去50年里,各种出版物上出现了关于这些药物在儿科患者中使用得当与不当的报道。针对本文件,小儿麻醉学会任命了一个特别工作组来评估现有文献,并就儿童围手术期阿片类药物给药最突出的方面制定建议。这些建议根据现有证据的力度进行分级,对于缺乏证据的问题则采用专家共识。这些建议的目标是解决术后给儿童使用阿片类药物的最重要问题,包括疼痛的适当评估、接受阿片类药物治疗患者的监测、阿片类药物剂量考量、阿片类药物治疗的副作用、阿片类药物给药策略以及镇痛效果评估。计划定期更新,每两年重新发布一次指南。