Analgesia in pediatric abdominal surgery

Jan Geudens , An Teunkens
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Abstract

Adequate analgesia is a key component of pediatric abdominal surgery. Multimodal analgesia, using different pharmacological products and locoregional techniques, is increasingly used in clinical practice.
This study aims to provide a clear overview of the different modalities used in abdominal surgery in the pediatric population. We conducted a literature review in which relevant articles, which focused on the efficacy, side effects, and locoregional techniques of pharmacological products, were included and analyzed.
The combined use of classic analgesics (such as paracetamol and nonsteroidal anti-inflammatory drugs) or alpha-2 agonists together with opioids can ensure lower opioid use, which in turn reduces the risk of adverse effects. Various locoregional techniques, particularly the transversus abdominis plane block and quadratus lumborum block, have also been shown to be effective in abdominal surgery in the pediatric population. Age-specific differences in analgesic use were investigated, with the importance of correct weight-based dosing and proper monitoring of vital parameters being particularly crucial. Further research focusing on specific surgical procedures could identify the most indicated technique.
In conclusion, sufficient evidence supports the use of multimodal analgesia as the standard approach in pediatric abdominal surgery.

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