Moore David L, Ding Lili, Yang Fang, Lee Jiwon, Sadhasivam Senthilkumar, Kandil Ali
Department of Anesthesiology and Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Children (Basel). 2025 Aug 25;12(9):1117. doi: 10.3390/children12091117.
We wished to demonstrate the utility of a novel quantitative assessment tool for the efficacy of regional anesthesia in children.
The authors examined the records of all patients evaluated by the acute pain service during a 6-month period at a large quaternary-care pediatric hospital. The morphine equivalency rate (MER) in mcg/kg/hour was employed to compare the opioid use in children undergoing similar procedures with and without regional anesthesia (RA).
A total of 744 patients were included in this study, 333 of whom received RA. The RA group demonstrated a statistical and clinical benefit from having regional anesthesia, as demonstrated by the MER, compared to the non-RA group.
Objective measurements of RA in adults are overshadowed by subjective evidence of surgical tolerance in awake or lightly sedated patients. However, in pediatrics, objective measures are still needed to highlight the importance and utility of RA. Such objective tools could impact the adoption of RA by our surgical colleagues and have a long-term impact on opioid use and even abuse. We implemented the MER to quantify the benefit of RA. Given the adverse effects of opioids on gut motility, the incidence of nausea and vomiting, hypersensitivity reactions, and ubiquitous potential for abuse, the MER objectively demonstrates RA's impact on pediatric surgical patients and why its utilization as an assessment tool could ultimately change practice.
我们希望证明一种新型定量评估工具在评估儿童区域麻醉效果方面的实用性。
作者检查了一家大型四级护理儿科医院急性疼痛服务部门在6个月期间评估的所有患者的记录。采用每千克每小时微克的吗啡等效率（MER）来比较接受和未接受区域麻醉（RA）的类似手术患儿的阿片类药物使用情况。
本研究共纳入744例患者，其中333例接受了RA。与非RA组相比，RA组通过MER显示出区域麻醉具有统计学和临床益处。
在成人中，区域麻醉的客观测量被清醒或轻度镇静患者手术耐受性的主观证据所掩盖。然而，在儿科中，仍需要客观测量来突出区域麻醉的重要性和实用性。这样的客观工具可能会影响我们外科同事对区域麻醉的采用，并对阿片类药物的使用甚至滥用产生长期影响。我们采用MER来量化区域麻醉的益处。鉴于阿片类药物对肠道蠕动、恶心和呕吐发生率、过敏反应以及普遍存在的滥用可能性的不良影响，MER客观地证明了区域麻醉对小儿外科患者的影响，以及为何将其用作评估工具最终可能改变实践。
