The management of perioperative pain in craniosynostosis repair: a systematic literature review of the current practices and guidelines for the future
Mortada Hatan, AlKhashan Raghad, Alhindi Nawaf, AlWaily Haifa B., Alsadhan Ghada A., Alrobaiea Saad, Arab Khalid,
소속 상세정보
( Mortada Hatan ) - King Saud University King Saud University Medical City Surgery Department
( AlKhashan Raghad ) - King Saud University Faculty of Medicine
( Alhindi Nawaf ) - King Abdulaziz University College of Medicine
( AlWaily Haifa B. ) - King Saud University Faculty of Medicine
( Alsadhan Ghada A. ) - King Saud University Faculty of Medicine
( Alrobaiea Saad ) - Security Forces Hospital Department of Plastic Surgery
( Arab Khalid ) - King Saud University College of Medicine Department of Surgery
Abstract
Background: Craniosynostosis is a condition characterized by a premature fusion of one or more cranial sutures. The surgical repair of craniosynostosis causes significant pain for the child. A key focus of craniosynostosis repair is developing effective strategies to manage perioperative pain. This study aimed to review perioperative pain control strategies for craniosynostosis repair systematically.
Methods: Guidelines for reporting systematic reviews and meta-analyses were used in the design of this review. In May 2022, the following databases were used to conduct the literature search: MEDLINE, Cochrane, EMBASE, and Google Scholar. A search was performed using MeSH terms “craniosynostosis,” “pain management,” and “cranioplasty.”
Results: The literature review yielded 718 publications. After applying our inclusion criteria, 17 articles were included, accounting for a total of 893 patients. During the postoperative period, most studies used multimodal analgesia, primarily opioids, and acetaminophen. In the postoperative period, oral ibuprofen was the most commonly used NSAID, rectal codeine, and acetaminophen were the most commonly used weak opioids, and continuous remifentanil infusion was the most commonly used potent opioid.
Conclusion: The authors determined the best pain management options for pediatric patients undergoing cranioplasty by analyzing the most commonly used analgesics. A high-quality clinical trial comparing different types of analgesic combinations would be a valuable addition to the present literature.
키워드
Pain control; Cranial vault reconstruction; Craniosynostosis; Pain management; Cranioplasty
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