Evidence map›Paper›PMID 38490692›Full record

ArticleBMJ paediatrics open2024

Postoperative pain and pain management following selective dorsal rhizotomy.

Isabel G Adams, Ramanie Jayaweera, Jennifer Lewis, Nadia Badawi, Mohamed E Abdel-Latif, Simon Paget

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Isabel G AdamsAustralian National University College of Health and Medicine, Canberra, Australian Capital Territory, Australia.ORCID http://orcid.org/0000-0001-5699-3759
Ramanie JayaweeraThe Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Jennifer LewisThe Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Nadia BadawiDiscipline of Child and Adolescent Health, University of Sydney, Cerebral Palsy Alliance, Sydney, New South Wales, Australia.
Mohamed E Abdel-LatifAustralian National University College of Health and Medicine, Canberra, Australian Capital Territory, Australia.ORCID http://orcid.org/0000-0003-4306-2933
Simon PagetThe Children's Hospital at Westmead, Westmead, New South Wales, Australia simon.paget@sydney.edu.au.
Australian National University · AUChildren's Hospital at Westmead · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelective dorsal rhizotomy (SDR) is a neurosurgical procedure that reduces lower limb spasticity, performed in some children with spastic diplegic cerebral palsy. Effective pain management after SDR is essential for early rehabilitation. This study aimed to describe the anaesthetic and early pain management, pain and adverse events in children following SDR.

methodsThis was a retrospective cohort study. Participants were all children who underwent SDR at a single Australian tertiary hospital between 2010 and 2020. Electronic medical records of all children identified were reviewed. Data collected included demographic and clinical data (pain scores, key clinical outcomes, adverse events and side effects) and medications used during anaesthesia and postoperative recovery.

results22 children (n=8, 36% female) had SDR. The mean (SD) age at surgery was 6 years and 6 months (1 year and 4 months). Common intraoperative medications used were remifentanil (100%), ketamine (95%), paracetamol (91%) and sevoflurane (86%). Postoperatively, all children were prescribed opioid nurse-controlled analgesia (morphine, 36%; fentanyl, 36%; and oxycodone, 18%) and concomitant ketamine infusion. Opioid doses were maximal on the day after surgery. The mean (SD) daily average pain score (Wong-Baker FACES scale) on the day after surgery was 1.4 (0.9), decreasing to 1.0 (0.5) on postoperative day 6 (POD6). Children first attended the physiotherapy gym on median day 7 (POD8, range 7-8). Most children experienced mild side effects or adverse events that were managed conservatively. Common side effects included constipation (n=19), nausea and vomiting (n=18), and pruritus (n=14). No patient required return to theatre, ICU admission or prolonged inpatient stay.

conclusionsMost children achieve good pain management following SDR with opioid and ketamine infusions. Adverse events, while common, are typically mild and managed with medication or therapy. This information can be used as a baseline to improve postoperative care and to support families' understanding of SDR before surgery.

Indexed as

KetamineRhizotomyAnalgesics, OpioidAustraliaChildFemaleHumansMalePain ManagementPostoperative PainRetrospective StudiesAnalgesics, OpioidKetamineAnalgesiaNeurosurgeryPainRehabilitation

Identifiers

PMID38490692
PMCPMC10946356
OpenAlexW4392846921

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.