Manejo del dolor posoperatorio por cirugía de columna en la población pediátrica. Resultados preliminares.[Pain mangement following spinal surgeries in pediatric patients. Preliminary results]
Barra lateral del artículo
Publicado:
ago 5, 2019
Palabras clave:
dolor posoperatorio, guías prácticas de dolor, analgesia, terapia multimodal, cirugía de columna, pediátría. Postoperative pain, pain management guidelines, pain relief, multimodal therapy, spinal surgery, pediatrics.
Contenido principal del artículo
Resumen
Introducción: Aproximadamente el 80% de los pacientes pediátricos sometidos a cirugía de columna refiere dolor moderado o severo en el posoperatorio inmediato.Objetivos: Describir la presencia de dolor y su intensidad durante el posoperatorio de una cirugía de columna en pacientes pediátricos y evaluar la eficacia del tratamiento analgésico actual.Materiales y Métodos: Se evaluaron pacientes sometidos a cirugía de columna, de entre 10 y 18 años, con capacidad mental para entender el propósito del estudio. Se utilizó el esquema de medicación estándar actual posoperatorio del hospital. Se constataron la presencia del dolor, la hora de comienzo, la localización y la intensidad (escala de valoración numérica), entre otras variables.Resultados: Se evaluó a 84 pacientes pediátricos, con una edad promedio de 12 años y 9 meses, al momento de la cirugía. Las etiología fueron: idiopática (41 casos), neuropática (14 casos), sindrómica (10 casos), muscular (7 casos) y misceláneas (12 casos). El puntaje promedio en la escala de valoración numérica fue de 2,1 antes de la cirugía; de 7,3 el día 1 posoperatorio y de 3,3 el día 6 posoperatorio/alta. El tiempo promedio de internación fue de 6.3 días, el costo económico global de la internación fue de USD1090 por paciente.Conclusiones: Un importante porcentaje de pacientes pediátricos refiere dolor moderado o severo en el posoperatorio de una cirugía de columna, tan solo la mitad recibe un esquema de manejo de dolor estandarizado y adecuado. El objetivo ulterior de este estudio será protocolizar el manejo del dolor con un enfoque multimodal.AbstractIntroduction: Around 80% of pediatric patients who undergo spine surgery report moderate to severe pain in the immediate postoperative (POP) period, and only half of them are treated according to an adequate and standardized pain management scheme.Objectives: To describe the type and intensity of POP pain in children who underwent spinal surgery and evaluate the effectiveness of the current pain management protocol.Materials and Methods: We assessed children between 10 and 18 years of age who were able to understand the purpose of the study. We recorded presence of pain, time of POP pain onset, location, and referred intensity of the pain using a numeric rating scale (NRS), among other variables.Results: Overall, 84 pediatric patients were evaluated. Mean age at surgery: 12 years and 9 months. Etiology: idiopathic (41 patients), neuropathic (14 patients), syndromic (10 patients), muscular (7 patients), and miscellaneous (12 patients). Mean preoperative NRS was 2.1 and 7.3 on POP day 1, 6.6 on POP day 2, 6.2 on POP day 3, 5.1 on POP day 4, 3.7 on POP day 5, and 3.3 on POP day 6/at discharge. Mean hospital stay was6.3 days. The mean cost of hospital stay was USD 1090 per patient.Conclusions: A high percentage of pediatric patients who underwent spinal surgery reported moderate to severe pain in the POP period, and just half of them received a standardized pain management protocol. A pain management protocol with a multimodal focus should be considered in a near future.
Descargas
La descarga de datos todavía no está disponible.
Métricas
Cargando métricas ...
Detalles del artículo
Cómo citar
Piantoni, L., Tello, C. A., Francheri Wilson, I. A., Remondino, R., Galaretto, E., Bersusky, E. S., & Noel, M. A. (2019). Manejo del dolor posoperatorio por cirugía de columna en la población pediátrica. Resultados preliminares.[Pain mangement following spinal surgeries in pediatric patients. Preliminary results]. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 84(3), 224-235. https://doi.org/10.15417/issn.1852-7434.2019.84.3.931
Número
Sección
Investigación Clínica
Derechos de autor 2019 Revista de la Asociación Argentina de Ortopedia y Traumatología
La aceptación del manuscrito por parte de la revista implica la no presentación simultánea a otras revistas u órganos editoriales. La RAAOT se encuentra bajo la licencia Creative Commons 4.0. Atribución-NoComercial-CompartirIgual (http://creativecommons.org/licenses/by-nc-sa/4.0/deed.es). Se puede compartir, copiar, distribuir, alterar, transformar, generar una obra derivada, ejecutar y comunicar públicamente la obra, siempre que: a) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); b) no se usen para fines comerciales; c) se mantengan los mismos términos de la licencia.
En caso de que el manuscrito sea aprobado para su próxima publicación, los autores conservan los derechos de autor y cederán a la revista los derechos de la publicación, edición, reproducción, distribución, exhibición y comunicación a nivel nacional e internacional en las diferentes bases de datos, repositorios y portales.
Se deja constancia que el referido artículo es inédito y que no está en espera de impresión en alguna otra publicación nacional o extranjera.
Por la presente, acepta/n las modificaciones que sean necesarias, sugeridas en la revisión por los pares (referato), para adaptar el trabajo al estilo y modalidad de publicación de la Revista.
Citas
1. Chou R, Gordon DB, de León-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Guidelines on the Management of Postoperative Pain Management of Postoperative Pain: A Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain 2016;17(2):131-57. https://doi.org/10.1016/j.jpain.2015.12.008
2. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of postsurgical pain: Results from a US national survey. Curr Med Res Opin 2014;30:149-60. https://doi.org/10.1185/03007995.2013.860019
3. Kehlet H, Jensen T, Woolf C. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367:1618-25. https://doi.org/10.1016/S0140-6736(06)68700-X
4. Chou R, Thames LL, Dana T, Pappas M, Mitchell JP. Evidence review on the management of postoperative pain. Glenview, IL: American Pain Society; 2016.
5. Egbert LD, Battit GE, Welch CE, Bartlett MK. Reduction of postoperative pain by encouragement and instruction of patients. A study of doctor-patient rapport. N Engl J Med 1964:270:825-7. https://doi.org/10.1056/NEJM196404162701606
6. Langer EJ, Janis IL, Wolfer JA. Reduction of psychological stress in surgical patients. J Exp Soc Psychol 1975;11:155-65. https://doi.org/10.1016/S0022-1031(75)80018-7
7. Crowe J, Henderson J. Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther 2003;70:88-96. https://doi.org/ 10.1177/000841740307000204
8. Doering S, Katzlberger F, Rumpold G, Roessler S, Hofstoetter B, Schatz DS, et al. Videotape preparation of patients before hip replacement surgery reduces stress. Psychosom Med 2000;62:365-73. PMID: 10845350
9. Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. A randomized, controlled trial. Ann Intern Med 2000;133:253-62. https://doi.org/10.7326/0003-4819-133-4 200008150-00007
10. Wilson JF. Behavioral preparation for surgery: Benefit or harm? J Behav Med 1981;4:79-102. PMID: 7026795
11. Kankkunen P, Vehviläinen-Julkunen K, Pietilä AM, Halonen P. Is the sufficiency of discharge instructions related to children’s postoperative pain at home after day surgery? Scand J Caring Sci 2003;17:365-72. PMID: 14629639
12. Haber L. How to accelerate recovery of AIS patients after posterior spinal fusion. Multiple modality pain protocols.
Scoliosis Research Society Annual Meeting, Minneapolis, MN, 2015.
13. Beyer JE, Bournaki MC. Assessment and management of postoperative pain in children. Pediatrician 1989;16:30-8. PMID: 2566985
14. Pettersson PH, Jakobsson J, Owall A. Intravenous acetaminophen reduced the use of opioids compared with oral
administration after coronary artery bypass grafting. J Cardiothorac Vasc Anesth 2005;19:306-9. PMID: 16130055
15. Li Q, Zhang Z, Cai Z. High-dose ketorolac affects adult spinal fusion: a meta-analysis of the effect of perioperative non steroidal anti-inflammatory drugs on spinal fusion. Spine 2011;36: E461-E468. https://doi.org/10.1097/BRS.0b013e3181dfd163
16. Dodwell ER, Latorre JG, Parisini E, Zwettler E, Chandra D, Mulpuri K, et al. NSAID exposure and risk of nonunion: A meta-analysis of case-control and cohort studies. Calcif Tissue Int 2010;87:193-202. https://doi.org/10.1007/s00223-010-9379-7
17. Sucato DJ, Lovejoy JF, Agrawal S, Elerson E, Nelson T, McClung A. Postoperative ketorolac does not predispose to pseudoarthrosis following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Spine 2008;33:1119-24. https://doi.org/10.1097/BRS.0b013e31816f6a2a
18. Rusy LM, Hainsworth KR, Nelson TJ, Czarnecki ML, Tassone JC, Thometz JG, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg 2010;110:1393-8. https://doi.org/10.1213/ANE.0b013e3181d41dc
19. Amin SM, Amr YM. Comparison between preemptive gabapentin and paracetamol for pain control after adenotonsillectomy in children. Anesth Essays Res 2011;5:167-70. https://doi.org/10.4103/0259-1162.94758
20. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 2008;101:700-4. https://doi.org/10.1093/bja/aen244
21. Chang SH, Lee HW, Kim HK, Kim SH, Kim DK. An evaluation of perioperative pregabalin for prevention and attenuation of postoperative shoulder pain after laparoscopic cholecystectomy. Anesth Analg 2009;109:1284-6. https://doi.org/10.1213/ane.0b013e3181b4874d
22. Hayes J, Pehora C, Bissonnette B. The use of NSAIDs in pediatric scoliosis surgery - a survey of physicians’ prescribing practice. Paediatr Anaesth 2009;19(8):756-63. https://doi.org/10.1111/j.1460-9592.2009.03060.x
23. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003;97:534-40. https://doi.org/10.1213/01.ane.0000068822.10113.9e
24. Bastrom TP, Marks MC, Yaszay B, Newton PO; Harms Study Group. Prevalence of postoperative pain in adolescent idiopathic scoliosis and the association with preoperative pain. Spine (Phila Pa 1976) 2013;38(21):1848-52. https://doi.org/10.1097/BRS.0b013e3182a4aa97
25. Beyer JE, Villarruel AM, Deynes MJ. The Oucher: User’s manual and technical report.
Disponible en: www.oucher.org/downloads/2009_Users_Manual.pdf. Consulta: 8 de enero, 2016.
26. Freedman BM, O’Hara E. Pregabalin has opioid-sparing effects following augmentation mammaplasty. Aesthet Surg J 2008;28:421-4. https://doi.org/10.1016/j.asj.2008.04.004
27. Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K. Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth 2008;100:834-40. https://doi.org/10.1093/bja/aen098
28. Bradley EH, Herrin J, Mattera JA, Holmboe ES, Wang Y, Frederick P, et al. Quality improvement efforts and hospital performance: rates of beta-blocker prescription after acute myocardial infarction. Med Care 2005;43:282-92. PMID: 15725985
29. Buchholz M, Karl HW, Pomietto M, Lynn A. Pain scores in infants: a modified infant pain scale versus visual analogue. J Pain Symptom Manage 1998;15:117-24. PMID: 9494310
30. Tramèr MR, Williams JE, Carroll D, Wiffen PJ, Moore RA, McQuay HJ. Comparing analgesic efficacy of nonsteroidal anti-inflammatory drugs given by different routes in acute and chronic pain: a qualitative systematic review. Acta Anaesthesiol Scand 1998;42:71-9. PMID: 9527748
31. U.S. Food and Drug Administration. Extended release-long acting opioid analgesics.
Disponible en: www.fda.gov/Safety/MedWatch/SafetyInformation/ucm396503. htm. Consulta: 9 de diciembre, 2015.
32. Saudan S, Habre W, Ceroni D, Meyer PA, Greenberg RS, Kaelin A, et al. Safety and efficacy of patient controlled epidural analgesia following pediatric spinal surgery. Paediatr Anaesth 2008;18:132-9. https://doi.org/10.1111/j.1460-9592.2007.02383.x
33. Jarzyna D, Jungquist CR, Pasero C, Willens JS, Nisbet A, Oakes L, et al. American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Sedation and Respiratory Depression. Pain Manag Nurs 2011;12:118-45. https://doi.org/10.1016/j.pmn.2011.06.008
34. Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonesteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg 2010;110:1170-9. https://doi.org/10.1213/ANE.0b013e3181cf9281
35. Ravish M, Muldowney B, Becker A, Hetzel S, McCarthy JJ, Nemeth BA, et al. Pain management in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: combined intrathecal morphine and continuous epidural versus PCA. J Pediatr Orthop 2012;32(8):799-804. https://doi.org/10.1097/BPO.0b013e3182694f00
36. Reynolds MA. Postoperative pain management discharge teaching in a rural population. Pain Manag Nurs 2009;10:76-84. https://doi.org/10.1016/j.pmn.2008.07.003
37. Sieberg CB, Simons LE, Eldestein MR, DeAngelis MR, Pielech M, Sethna N, et al. Pain prevalence and trajectories following pediatric spinal fusion surgery. J Pain 2013;14(12):1694-702. https://doi.org/10.1016/j.jpain.2013.09.005
38. Milbrandt TA, Singhal M, Minter C, McClung A, Talwalkar VR, Iwinski HJ, et al. A comparison of three methods of pain control for posterior spinal fusions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2009;34(14):1499-503. https://doi.org/10.1097/BRS.0b013e3181a90ceb
39. Poe-Kochert C, Tripi PA, Potzman J, Son-Hing JP, Thompson GH. Continuous intravenous morphine infusion for postoperative analgesia following posterior spinal fusion for idiopathic scoliosis. Spine (Phila Pa 1976) 2010;35(7):754-7. https://doi.org/10.1097/BRS.0b013e3181bc9a00
40. Landman Z, Oswald T, Sanders J, Diab M; Spinal Deformity Study Group. Prevalence and predictors of pain in surgical treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2011;36(10):825-9. https://doi.org/10.1097/BRS.0b013e3181de8c2b
41. Hiller A, Helenius I, Nurmi E, Neuvonen PJ, Kaukonen M, Hartikainen T, et al. Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents. Spine (Phila Pa 1976) 2012;15;37(20):E1225-31. https://doi.org/ 10.1097/BRS.0b013e318263165c
42. Rullander AC, Jonsson H, Lundström M, Lindh V. Young people’s experiences with scoliosis surgery: a survey of pain, nausea, and global satisfaction. Orthop Nurs 2013;32(6):327(33):334-5. https://doi.org/10.1097/NOR.0000000000000007
43. Connelly M, Fulmer RD, Prohaska J, Anson L, Dryer L, Thomas V, et al. Predictors of postoperative pain trajectories in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2014;39(3):E174-81. https://doi.org/10.1097/BRS.0000000000000099
44. Mayell A, Srinivasan I, Campbell F, Peliowski A. Analgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial. Paediatr Anaesth 2014;24(12):1239-44. https://doi.org/10.1111/pan.12524
2. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of postsurgical pain: Results from a US national survey. Curr Med Res Opin 2014;30:149-60. https://doi.org/10.1185/03007995.2013.860019
3. Kehlet H, Jensen T, Woolf C. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367:1618-25. https://doi.org/10.1016/S0140-6736(06)68700-X
4. Chou R, Thames LL, Dana T, Pappas M, Mitchell JP. Evidence review on the management of postoperative pain. Glenview, IL: American Pain Society; 2016.
5. Egbert LD, Battit GE, Welch CE, Bartlett MK. Reduction of postoperative pain by encouragement and instruction of patients. A study of doctor-patient rapport. N Engl J Med 1964:270:825-7. https://doi.org/10.1056/NEJM196404162701606
6. Langer EJ, Janis IL, Wolfer JA. Reduction of psychological stress in surgical patients. J Exp Soc Psychol 1975;11:155-65. https://doi.org/10.1016/S0022-1031(75)80018-7
7. Crowe J, Henderson J. Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther 2003;70:88-96. https://doi.org/ 10.1177/000841740307000204
8. Doering S, Katzlberger F, Rumpold G, Roessler S, Hofstoetter B, Schatz DS, et al. Videotape preparation of patients before hip replacement surgery reduces stress. Psychosom Med 2000;62:365-73. PMID: 10845350
9. Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. A randomized, controlled trial. Ann Intern Med 2000;133:253-62. https://doi.org/10.7326/0003-4819-133-4 200008150-00007
10. Wilson JF. Behavioral preparation for surgery: Benefit or harm? J Behav Med 1981;4:79-102. PMID: 7026795
11. Kankkunen P, Vehviläinen-Julkunen K, Pietilä AM, Halonen P. Is the sufficiency of discharge instructions related to children’s postoperative pain at home after day surgery? Scand J Caring Sci 2003;17:365-72. PMID: 14629639
12. Haber L. How to accelerate recovery of AIS patients after posterior spinal fusion. Multiple modality pain protocols.
Scoliosis Research Society Annual Meeting, Minneapolis, MN, 2015.
13. Beyer JE, Bournaki MC. Assessment and management of postoperative pain in children. Pediatrician 1989;16:30-8. PMID: 2566985
14. Pettersson PH, Jakobsson J, Owall A. Intravenous acetaminophen reduced the use of opioids compared with oral
administration after coronary artery bypass grafting. J Cardiothorac Vasc Anesth 2005;19:306-9. PMID: 16130055
15. Li Q, Zhang Z, Cai Z. High-dose ketorolac affects adult spinal fusion: a meta-analysis of the effect of perioperative non steroidal anti-inflammatory drugs on spinal fusion. Spine 2011;36: E461-E468. https://doi.org/10.1097/BRS.0b013e3181dfd163
16. Dodwell ER, Latorre JG, Parisini E, Zwettler E, Chandra D, Mulpuri K, et al. NSAID exposure and risk of nonunion: A meta-analysis of case-control and cohort studies. Calcif Tissue Int 2010;87:193-202. https://doi.org/10.1007/s00223-010-9379-7
17. Sucato DJ, Lovejoy JF, Agrawal S, Elerson E, Nelson T, McClung A. Postoperative ketorolac does not predispose to pseudoarthrosis following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Spine 2008;33:1119-24. https://doi.org/10.1097/BRS.0b013e31816f6a2a
18. Rusy LM, Hainsworth KR, Nelson TJ, Czarnecki ML, Tassone JC, Thometz JG, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg 2010;110:1393-8. https://doi.org/10.1213/ANE.0b013e3181d41dc
19. Amin SM, Amr YM. Comparison between preemptive gabapentin and paracetamol for pain control after adenotonsillectomy in children. Anesth Essays Res 2011;5:167-70. https://doi.org/10.4103/0259-1162.94758
20. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 2008;101:700-4. https://doi.org/10.1093/bja/aen244
21. Chang SH, Lee HW, Kim HK, Kim SH, Kim DK. An evaluation of perioperative pregabalin for prevention and attenuation of postoperative shoulder pain after laparoscopic cholecystectomy. Anesth Analg 2009;109:1284-6. https://doi.org/10.1213/ane.0b013e3181b4874d
22. Hayes J, Pehora C, Bissonnette B. The use of NSAIDs in pediatric scoliosis surgery - a survey of physicians’ prescribing practice. Paediatr Anaesth 2009;19(8):756-63. https://doi.org/10.1111/j.1460-9592.2009.03060.x
23. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003;97:534-40. https://doi.org/10.1213/01.ane.0000068822.10113.9e
24. Bastrom TP, Marks MC, Yaszay B, Newton PO; Harms Study Group. Prevalence of postoperative pain in adolescent idiopathic scoliosis and the association with preoperative pain. Spine (Phila Pa 1976) 2013;38(21):1848-52. https://doi.org/10.1097/BRS.0b013e3182a4aa97
25. Beyer JE, Villarruel AM, Deynes MJ. The Oucher: User’s manual and technical report.
Disponible en: www.oucher.org/downloads/2009_Users_Manual.pdf. Consulta: 8 de enero, 2016.
26. Freedman BM, O’Hara E. Pregabalin has opioid-sparing effects following augmentation mammaplasty. Aesthet Surg J 2008;28:421-4. https://doi.org/10.1016/j.asj.2008.04.004
27. Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K. Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth 2008;100:834-40. https://doi.org/10.1093/bja/aen098
28. Bradley EH, Herrin J, Mattera JA, Holmboe ES, Wang Y, Frederick P, et al. Quality improvement efforts and hospital performance: rates of beta-blocker prescription after acute myocardial infarction. Med Care 2005;43:282-92. PMID: 15725985
29. Buchholz M, Karl HW, Pomietto M, Lynn A. Pain scores in infants: a modified infant pain scale versus visual analogue. J Pain Symptom Manage 1998;15:117-24. PMID: 9494310
30. Tramèr MR, Williams JE, Carroll D, Wiffen PJ, Moore RA, McQuay HJ. Comparing analgesic efficacy of nonsteroidal anti-inflammatory drugs given by different routes in acute and chronic pain: a qualitative systematic review. Acta Anaesthesiol Scand 1998;42:71-9. PMID: 9527748
31. U.S. Food and Drug Administration. Extended release-long acting opioid analgesics.
Disponible en: www.fda.gov/Safety/MedWatch/SafetyInformation/ucm396503. htm. Consulta: 9 de diciembre, 2015.
32. Saudan S, Habre W, Ceroni D, Meyer PA, Greenberg RS, Kaelin A, et al. Safety and efficacy of patient controlled epidural analgesia following pediatric spinal surgery. Paediatr Anaesth 2008;18:132-9. https://doi.org/10.1111/j.1460-9592.2007.02383.x
33. Jarzyna D, Jungquist CR, Pasero C, Willens JS, Nisbet A, Oakes L, et al. American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Sedation and Respiratory Depression. Pain Manag Nurs 2011;12:118-45. https://doi.org/10.1016/j.pmn.2011.06.008
34. Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonesteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg 2010;110:1170-9. https://doi.org/10.1213/ANE.0b013e3181cf9281
35. Ravish M, Muldowney B, Becker A, Hetzel S, McCarthy JJ, Nemeth BA, et al. Pain management in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: combined intrathecal morphine and continuous epidural versus PCA. J Pediatr Orthop 2012;32(8):799-804. https://doi.org/10.1097/BPO.0b013e3182694f00
36. Reynolds MA. Postoperative pain management discharge teaching in a rural population. Pain Manag Nurs 2009;10:76-84. https://doi.org/10.1016/j.pmn.2008.07.003
37. Sieberg CB, Simons LE, Eldestein MR, DeAngelis MR, Pielech M, Sethna N, et al. Pain prevalence and trajectories following pediatric spinal fusion surgery. J Pain 2013;14(12):1694-702. https://doi.org/10.1016/j.jpain.2013.09.005
38. Milbrandt TA, Singhal M, Minter C, McClung A, Talwalkar VR, Iwinski HJ, et al. A comparison of three methods of pain control for posterior spinal fusions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2009;34(14):1499-503. https://doi.org/10.1097/BRS.0b013e3181a90ceb
39. Poe-Kochert C, Tripi PA, Potzman J, Son-Hing JP, Thompson GH. Continuous intravenous morphine infusion for postoperative analgesia following posterior spinal fusion for idiopathic scoliosis. Spine (Phila Pa 1976) 2010;35(7):754-7. https://doi.org/10.1097/BRS.0b013e3181bc9a00
40. Landman Z, Oswald T, Sanders J, Diab M; Spinal Deformity Study Group. Prevalence and predictors of pain in surgical treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2011;36(10):825-9. https://doi.org/10.1097/BRS.0b013e3181de8c2b
41. Hiller A, Helenius I, Nurmi E, Neuvonen PJ, Kaukonen M, Hartikainen T, et al. Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents. Spine (Phila Pa 1976) 2012;15;37(20):E1225-31. https://doi.org/ 10.1097/BRS.0b013e318263165c
42. Rullander AC, Jonsson H, Lundström M, Lindh V. Young people’s experiences with scoliosis surgery: a survey of pain, nausea, and global satisfaction. Orthop Nurs 2013;32(6):327(33):334-5. https://doi.org/10.1097/NOR.0000000000000007
43. Connelly M, Fulmer RD, Prohaska J, Anson L, Dryer L, Thomas V, et al. Predictors of postoperative pain trajectories in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2014;39(3):E174-81. https://doi.org/10.1097/BRS.0000000000000099
44. Mayell A, Srinivasan I, Campbell F, Peliowski A. Analgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial. Paediatr Anaesth 2014;24(12):1239-44. https://doi.org/10.1111/pan.12524