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A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure

Introduction: The continuous paravertebral blockade as part of the multimodal pain protocol is an effective regional technique to control pain after the Nuss procedure. We investigated the effectiveness of clonidine as an adjunct to paravertebral ropivacaine infusion. Methods: We conducted a retrosp...

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Autores principales: Visoiu, Mihaela, Sadhasivam, Senthilkumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954470/
https://www.ncbi.nlm.nih.gov/pubmed/36832322
http://dx.doi.org/10.3390/children10020193
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author Visoiu, Mihaela
Sadhasivam, Senthilkumar
author_facet Visoiu, Mihaela
Sadhasivam, Senthilkumar
author_sort Visoiu, Mihaela
collection PubMed
description Introduction: The continuous paravertebral blockade as part of the multimodal pain protocol is an effective regional technique to control pain after the Nuss procedure. We investigated the effectiveness of clonidine as an adjunct to paravertebral ropivacaine infusion. Methods: We conducted a retrospective study of 63 patients who underwent Nuss procedures and received bilateral paravertebral catheters. Data on demographics, surgical, anesthesia, and block characteristics, numeric rating pain scores (NRS), opioids consumption, hospital length of stay, complications, and side effects from medication administration were collected in children who received paravertebral ropivacaine 0.2% infusion without (N = 45) and with clonidine (1 mcg/mL) (N = 18). Results: The two groups had similar demographics, although the clonidine group had higher Haller indices (6.5 (4.8, 9.4) vs. 4.8 (4.1, 6.6), p = 0.013). The clonidine group required less morphine equivalent/kg on postoperative day 2 (median, interquartile range 0.24 (0.22, 0.31) vs. 0.47 (0.29, 0.61) p = 0.002). There was no difference in median NRS pain scores. Both groups had similar catheter infusion durations, hospital length of stay, and complication rates. Conclusion: A postoperative pain management plan that includes paravertebral analgesia, including clonidine as an adjunct, may be considered to minimize opioid administration for patients undergoing primary Nuss repair.
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spelling pubmed-99544702023-02-25 A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure Visoiu, Mihaela Sadhasivam, Senthilkumar Children (Basel) Article Introduction: The continuous paravertebral blockade as part of the multimodal pain protocol is an effective regional technique to control pain after the Nuss procedure. We investigated the effectiveness of clonidine as an adjunct to paravertebral ropivacaine infusion. Methods: We conducted a retrospective study of 63 patients who underwent Nuss procedures and received bilateral paravertebral catheters. Data on demographics, surgical, anesthesia, and block characteristics, numeric rating pain scores (NRS), opioids consumption, hospital length of stay, complications, and side effects from medication administration were collected in children who received paravertebral ropivacaine 0.2% infusion without (N = 45) and with clonidine (1 mcg/mL) (N = 18). Results: The two groups had similar demographics, although the clonidine group had higher Haller indices (6.5 (4.8, 9.4) vs. 4.8 (4.1, 6.6), p = 0.013). The clonidine group required less morphine equivalent/kg on postoperative day 2 (median, interquartile range 0.24 (0.22, 0.31) vs. 0.47 (0.29, 0.61) p = 0.002). There was no difference in median NRS pain scores. Both groups had similar catheter infusion durations, hospital length of stay, and complication rates. Conclusion: A postoperative pain management plan that includes paravertebral analgesia, including clonidine as an adjunct, may be considered to minimize opioid administration for patients undergoing primary Nuss repair. MDPI 2023-01-20 /pmc/articles/PMC9954470/ /pubmed/36832322 http://dx.doi.org/10.3390/children10020193 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Visoiu, Mihaela
Sadhasivam, Senthilkumar
A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title_full A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title_fullStr A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title_full_unstemmed A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title_short A Retrospective Study Comparing Outcomes of Paravertebral Clonidine Infusion for Pediatric Patients Undergoing Nuss Procedure
title_sort retrospective study comparing outcomes of paravertebral clonidine infusion for pediatric patients undergoing nuss procedure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954470/
https://www.ncbi.nlm.nih.gov/pubmed/36832322
http://dx.doi.org/10.3390/children10020193
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