AANA journal
-
Pediatric surgical patients are a population at risk of inadequate pain management. The American Society of Anesthesiologists' 2012 Practice Guidelines for Acute Pain Management in the Perioperative Setting recommend a multimodal approach as the most effective way to prevent and treat pain in children. ⋯ Ketorolac and acetaminophen are the 2 nonopioid IV analgesics currently available for use in the United States. This article provides a review of the literature of IV ketorolac and IV acetaminophen regarding their pharmacology, analgesic efficacy, limitations, and practical considerations, with a focus on patients 16 years of age and younger.
-
Randomized Controlled Trial Comparative Study
Sevoflurane induction procedure: cost comparison between fixed 8% versus incremental techniques in pediatric patients.
This study compared 2 well-accepted and safe methods of pediatric inhalation induction using sevoflurane. Incremental and fixed 8% induction methods were evaluated for economic outcomes by comparing the amount of liquid sevoflurane consumed. We also tried to establish the relation between cost of induction and demographic parameters in both groups. ⋯ Use of the incremental method preferably over the fixed 8% method could save almost $18 US for each procedure. The volume of sevoflurane consumed during anesthesia induction was found to be independent of age, weight, or sex of pediatric patients. Both induction methods proved to be equally safe and acceptable to the patients.
-
Transversus abdominis plane (TAP) blocks are a relatively new regional anesthetic technique used in a multimodal approach to provide postoperative analgesia of the anterolateral abdominal wall. The technique for placing TAP blocks has evolved from a landmark technique to an ultrasound-guided technique. There are 3 common approaches for accessing the TAP: subcostal, midaxillary, and ilioinguinal-iliohypogastric. ⋯ The approach used is contingent on the type and location of the surgical procedure. Overall, TAP blocks reduce postoperative pain and opioid requirements, resulting in fewer side effects such as nausea and vomiting, respiratory depression, and sedation. Future studies should examine which type, concentration, and volume of local anesthetics are most effective.