If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Bupivacaine Reduces Pain in Obese Children Recovering From Laparoscopic Surgery: Presented at AAP By Crina Frincu-Mallos, PhD WASHINGTON, DC -- October 19, 2009 -- Bupivacaine is successful in reducing postoperative pain in children undergoing laparoscopic surgery to treat obesity, according to preliminary data reported here at the 2009 American Academy of Pediatrics (AAP) National Conference & Exhibition. The laparoscopic approach has significant benefits, among them being decreased postoperative pain. However, early in the recovery period, “children often experience abdominal and shoulder pain requiring significant amounts of opioids, potentially prolonging their hospitalisation,” said Frank J. Penna, MD, Children’s Hospital Boston, Boston, Massachusetts, on October 17. The prospective, randomised, controlled trial, Dr. Penna and his team aimed to evaluate the effectiveness of the local anaesthetic bupivacaine, administered intraperitoneally as an aerosol, in reducing postoperative pain in children. At the time of the report, 25 patients undergoing robot-assisted laparoscopic surgery at the Children’s Hospital Boston were randomised to receive either an 1.25 mg/kg dose of aerosolised intraperitoneal bupivacaine (n = 12) or an equivalent volume of saline (n = 13) after establishment of pneumoperitoneum. Patient characteristics were similar between groups. However, the children in the bupivacaine arm were slightly heavier compared with those in the saline arm, at 49.7 +- 24.3 kg and 45.0 +- 11.9 kg, respectively. The length of stay in the hospital was 1.2 +- 0.6 days for children receiving bupivacaine, compared with 1.4 +- 0.8 days for children receiving saline. The researchers analysed data on postoperative pain scores and opioid utilisation between the 2 groups. All patients received a standard anaesthetic and opioid analgesic regimen, explained Dr. Penna. At arrival in the postanaesthesia care unit, the pain score was 7 for the children on the bupivacaine arm and 10 for those on the saline arm (pain score 0 to 10, with 0 meaning no pain). At various time points after laparoscopy, the pain scores were consistently lower for children in the bupivacaine arm: 4 versus 7 (at 4 hours); 6 versus 9 (at 8 hours); 4 versus 9 (at 12 hours); 3 versus 6 (at 16 hours); and 4 versus 5 (at 20 hours). The postoperative opioid use was heavier in the saline arm compared with the bupivacaine arm: 0.34 +- 0.23 mg/kg versus 0.23 +- 0.14 mg/kg. With Institutional Review Board (IRB) approval, blood samples from all patients were obtained at different time points after receiving the aerosolised intraperitoneal bupivacaine (at 5, 15, 30, and 60 minutes). “Review was undertaken at midpoint of study per IRB standards,” said Dr. Penna. Patient enrolment is expected to be completed in the next 6 months. “Preliminary data suggest that the use of aerosolised intraperitoneal bupivacaine lowers mean and peak postoperative pain scores and opioid utilisation after laparoscopic surgery,” concluded Dr. Penna. [Presentation title: A Prospective Randomised Controlled Trial Assessing the Use of Aerosolized Intraperitoneal Bupivacaine in Reducing Postoperative Pain in Children Undergoing Laparoscopic Surgery: Preliminary Results. Abstract 7047]
|
