doiSerbia

The role of regional anesthesia in the postoperative analgesia in pediatric patients

Simić Dušica (University Children’s Hospital, Belgrade + Faculty of Medicine, Belgrade)
Simić Irena (University Children’s Hospital, Belgrade)
Stević Marija (University Children’s Hospital, Belgrade + Faculty of Medicine, Belgrade)
Jovičić Nevena (University Children’s Hospital, Belgrade)
Mitrović Maja (University Children’s Hospital, Belgrade)
Budić Ivana (Niš Clinical Centre, Clinic for Pediatric Surgery and Orthopedics, Niš + Faculty of Medicine, Niš)
Milenović Miodrag (Faculty of Medicine, Belgrade + Clinical Centre of Serbia, Emergency Centre, Belgrade)
Marjanović Vesna (Niš Clinical Centre, Clinic for Pediatric Surgery and Orthopedics, Niš + Faculty of Medicine, Niš)
Miličić Biljana (School of Dental Medicine, Belgrade)

Introduction/Objective. Pain is a disturbing experience associated with existing or potential tissue damage, with a sensory, emotional, cognitive, and social component. The aim of this study was to show the efficiency of regional anesthetic techniques in postoperative pain in children. Methods. The retrospective cohort study was conducted on a group of 564 pediatric patients during the period from 2013 to 2016. Types of regional anesthesia were classified into the following six groups: caudal, epidural, spinal block, upper limb blocks, lower limb blocks, and truncal nerve block. From statistical methods, we used descriptive statistical methods of absolute and relative numbers, measurements of variability, central tendencies for numerical features, and methods of inferential statistics. We used the χ2 test for the attributive features of observations. Results. In relation to the postoperative time when an analgesic was required, a statistically significant difference was observed in the age of children (p = 0.000), disease diagnosis (p = 0.000), type of block (p = 0.000), type of local anesthetic (p = 0.000), and type of anesthesia or sedation preoperatively (p = 0.005). Conclusion. Postoperative analgesia was most needed by older children and children who were awake during surgery. Children with injuries and tumors need postoperative analgesia the earliest. The longest postoperative analgesia was recorded in patients who received caudal block. The longest postoperative analgesia can be seen in patients who received levobupivacaine, bupivacaine or levobupivacaine combined with lidocaine to perform the block.

Keywords: regional anesthesia, child, pediatric patient, postoperative analgesia