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Post-operative non-steroidal anti-inflammatory drug use for pain in infant and paediatric cardiac surgery patients

Published online by Cambridge University Press:  26 November 2019

Dimitrios A. Savva Open the ORCID record for Dimitrios A. Savva [Opens in a new window] ,
Omayma A. Kishk ,
Jill A. Morgan ,
Jessica M. Biggs ,
Hyunuk Seung  and
Caroline Bauer
Dimitrios A. Savva*
Affiliation:
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
Omayma A. Kishk
Affiliation:
Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD 21201, USA
Jill A. Morgan
Affiliation:
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
Jessica M. Biggs
Affiliation:
Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD 21201, USA
Hyunuk Seung
Affiliation:
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
Caroline Bauer
Affiliation:
Department of Pediatric Cardiac Critical Care, University of Maryland Children’s Hospital – The Children’s Heart Program, Baltimore, MD 21201, USA
*
Author for correspondence: D. A. Savva, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, 20 N Pine Street, Baltimore, MD 21201, USA. E-mail: dimitrisavva92@gmail.com
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Abstract

Background:

Pain control is an important element of care for patients after surgery, leading to better outcomes, quicker transitions to recovery, and improvement in quality of life. The purpose of this study was to evaluate the safety and efficacy of non-steroidal anti-inflammatory drugs in children after cardiac surgery

Materials and Methods:

Patients between the ages of 1 month and 18 years of age, who received intravenous or oral non-steroidal anti-inflammataory drugs after cardiac surgery, from November 2015 until September 2017 were included in this study. The primary endpoints were non-steroidal anti-inflammataory drug-associated renal dysfunction and post-operative bleeding. Secondary endpoints examined the effect of non-steroidal anti-inflammataory drug use on total daily dose of narcotics, number of intravenous PRN narcotic doses received, and pain assessment score. Data were analysed using descriptive statistics for frequencies and ranges. Multivariate analysis was performed to measure the association of all predictors and outcomes. Wilcoxon singed-rank test was performed for secondary outcomes.

Results:

There was no association between the incidence of renal dysfunction and the use of or duration of non-steroidal anti-inflammataory drugs; in addition no association was found with increased chest tube output. There was a statistically significant reduction of patients’ median Face, Legs, Activity, Cry, Consolability (FLACC) scores (2–0; p = 0.003), seen within first 24 hours after initiation of ketorolac, and a significant reduction of morphine requirements seen from day 1 to day 2 (0.3 mg/kg versus 0.1 mg/kg; p < 0.001) and number of as-needed doses.

Conclusion:

Non-steroidal anti-inflammataory drugs in paediatric cardiac surgery patients are safe and effective for post-operative pain management.

Keywords

InfantspaediatricsNSAIDspost-operativecardiacsurgery
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1440 - 1444
Copyright
© Cambridge University Press 2019 

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