Observational studyPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2013
Opioid use after cardiac surgery in children with Down syndrome.
Observational study in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Opioid and benzodiazepine requirements in critically ill post-surgical children with down syndrome: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- Institutional and Regional Variation in Opioid Prescribing for Hospitalized Infants in the US.JAMA network open · 2024Article
- Comparison of modified thoracoabdominal nerve block through perichondral approach and subcostal transversus abdominis plane block for pain management in laparoscopic cholecystectomy: a randomized-controlled trial.The Korean journal of pain · 2023Article
- Down syndrome and congenital heart disease: perioperative planning and management.Journal of congenital cardiology · 2021Review
- Patient safety vulnerabilities for children with intellectual disability in hospital: a systematic review and narrative synthesis.BMJ paediatrics open · 2018Article
- Pharmacotherapeutic Considerations for Individuals with Down Syndrome.Pharmacotherapy · 2017Review
- Supportive care utilization and treatment toxicity in children with Down syndrome and acute lymphoid leukaemia at free-standing paediatric hospitals in the United States.British journal of haematology · 2016Article
- Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?Paediatric drugs · 2015Article
- Efficacy and Safety of Postoperative Dexmedetomidine Administration in Infants and Children Undergoing Cardiac Surgery: A Retrospective Cohort Study.Journal of pediatric intensive care · 2015Article
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7 authors at 2 institutions in 1 country.
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Abstract
objectivesTo determine the cumulative opioid doses administered to patients with Down syndrome after cardiac surgery and compare them with patients without Down syndrome.
designRetrospective observational comparative study.
settingPICU in a university-affiliated freestanding pediatric teaching hospital. PATIENTS: Infants and children who presented to our institution for heart surgery after July 1, 2008, and met the following criteria: 1) no opioid medications for 48 hours prior to surgery, 2) sternotomy approach with primary closure, and 3) no additional operative procedures in the 5 days after surgery. All patients with Down syndrome were included, and patients without Down syndrome with similar age, type of cardiac lesion, and length of surgical procedure were selected in a ~2:1 ratio, blinded to opioid exposure.
interventionsNone. MEASUREMENTS AND MAIN
resultsClinical and demographic data were extracted from electronic medical record data. Univariate analyses and multivariate linear regression modeling were performed to determine the influence of Down syndrome, patient characteristics, and clinical covariates on weight-adjusted opioid dose. The differences in median cumulative opioid doses between those with Down syndrome (n = 44) and those without Down syndrome (n = 77) were not significant in the first 24 hours (+0.39 mg/kg [95% CI, -0.45 to +1.39 mg/kg]) or 96 hours (+0.54 mg/kg [95% CI, -0.59 to +2.07 mg/kg]) after surgery. Age, cardiac bypass time, benzodiazepines, and neuromuscular blocking agents were significantly correlated with opioid dose, but Down syndrome, gender, pain score, creatinine, acetaminophen, nonsteroidal anti-inflammatory drugs, and steroid medications were not. Patients with Down syndrome had longer hospital stays; in multivariate analysis, higher opioid exposures in the first 96 hours after surgery and higher peak serum creatinine values correlated with longer hospitalization.
conclusionsThis cohort did not provide evidence for opioid resistance in patients with Down syndrome. Younger age, longer cardiac bypass time, exposure to benzodiazepines, and neuromuscular blockade did correlate with increased opioid doses after cardiac surgery.
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