Division of Orthopedic Surgery, Children's Hospital of Philadelphia.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
J Pediatr Orthop. 2021;41(10):e923-e928. doi: 10.1097/BPO.0000000000001956.
Improving pain control and decreasing opioid prescription and usage continue to be emphasized across both pediatric and adult populations. The purpose of this review is to provide a comprehensive assessment of recent literature and highlight new advancements pertaining to pain control in pediatric orthopaedic surgery.
An electronic search of the PubMed database was performed for keywords relating to perioperative pain management of pediatric orthopaedic surgery. Search results were filtered by publication date for articles published between January 1, 2015 and December 1, 2020 and yielded 404 papers.
A total of 32 papers were selected for review based upon new findings and significant contributions in the following categories: risk factors for increased opioid usage, opioid overprescribing and disposal, nonpharmacologic interventions, nonsteroidal anti-inflammatory drugs, peripheral nerve blocks, spine surgery specific considerations, surgical pathway modifications, and future directions.
There have been many advances in pain management for pediatric patients following orthopaedic surgery. Rapid recovery surgical care pathways are associated with shorter length of stay and improved pain control in pediatric spine surgery. Opioid overprescribing continues to be common and information regarding safe opioid disposal practices should be routinely provided for pediatric patients undergoing surgery.
Level IV-literature review.
在儿科和成人人群中，持续强调改善疼痛控制和减少阿片类药物的处方和使用。本综述的目的是全面评估最新文献，并强调小儿矫形外科手术中疼痛控制的新进展。
对 PubMed 数据库进行了电子检索，检索与小儿矫形外科手术围手术期疼痛管理相关的关键词。通过出版物日期对检索结果进行了筛选，仅纳入 2015 年 1 月 1 日至 2020 年 12 月 1 日期间发表的文章，共得到 404 篇论文。
根据新发现和以下类别中的重要贡献，共选择了 32 篇论文进行综述：阿片类药物使用增加的风险因素、阿片类药物过度处方和处置、非药物干预、非甾体抗炎药、周围神经阻滞、脊柱手术特定注意事项、手术途径修改以及未来方向。
小儿矫形手术后的疼痛管理取得了许多进展。快速康复外科护理途径与儿科脊柱手术中较短的住院时间和更好的疼痛控制相关。阿片类药物过度处方仍然很常见，应向接受手术的小儿患者常规提供安全的阿片类药物处置实践信息。
IV 级文献综述。
