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. 2024 Jan 8;13(2):349.
doi: 10.3390/jcm13020349.

Different Analgesia Techniques for Postoperative Pain in Children Undergoing Abdominal Surgery for Intractable Constipation: A Retrospective Cohort Study in a Single Tertiary Children's Hospital

Manouk Admiraal  1 , Fleur A E van der Burg  1 , Henning Hermanns  1 , Jeroen Hermanides  1 , Markus W Hollmann  1 , Marc A Benninga  2 , Justin de Jong  3 , Ramon R Gorter  3 , Markus F Stevens  1
Affiliations

Different Analgesia Techniques for Postoperative Pain in Children Undergoing Abdominal Surgery for Intractable Constipation: A Retrospective Cohort Study in a Single Tertiary Children's Hospital

Manouk Admiraal et al. J Clin Med. .

Abstract

Functional constipation in the pediatric population is a prevalent issue that is usually well managed. However, in rare cases, conservative treatment fails, and surgical intervention is necessary. This retrospective cohort study aimed to describe and compare different perioperative analgesic techniques in children undergoing major abdominal surgery for intractable constipation. Conducted between 2011 and 2021, this study enrolled patients under 18 years old who underwent initial major abdominal surgery for intractable constipation (i.e., creation of ostomy or subtotal colectomy). Patients were categorized according to the perioperative analgesic technique (i.e., systemic, neuraxial, or truncal block). Of 65 patients, 46 (70.8%) were female, and the median age was 13.5 [8.8-16.1] years during initial major abdominal surgery. Systemic analgesia was used in 43 (66.2%), neuraxial in 17 (26.2%), and truncal blocks in 5 (7.7%) of the surgeries. Patients with neuraxial analgesia reported less postoperative pain (median [interquartile range] numeric rating scale (NRS) 2.0 [0-4.0]), compared to systemic analgesia (5.0 [2.0-7.0], p < 0.001) and to truncal blocks (5.0 [3.0-6.5], p < 0.001). In this preliminary investigation, neuraxial analgesia appears to be the most effective approach to reducing acute postoperative pain in pediatric patients undergoing major abdominal surgery for intractable functional constipation. However, well-designed studies are warranted.

Keywords: child; constipation; operative; pain; pain management; postoperative; surgical procedures.

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Conflict of interest statement

The authors declare no conflicts of interest regarding the submitted work. Outside the submitted manuscript, M.W.H. serves as Executive Section Editor of Pharmacology with Anesthesia and Analgesia, Section Editor of Anesthesiology with the Journal of Clinical Medicine, and Editor of Frontiers in Physiology, and he has served as consultant for PAION, IDD, and Medical Developments Pharma.

Figures

Figure A1
Figure A1
Distribution of surgeries over time.
Figure 1
Figure 1
Flow diagram: NRS = numeric rating scale.
See this image and copyright information in PMC

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