Postoperative Pain Control After Supracondylar Humerus Fracture Fixation
BACKGROUND:Postoperative pain control in pediatric patients has become a priority for all institutions. There is a paucity of literature on pain control after orthopedic procedures in the pediatric population. The purpose of this study is to compare the efficacy of acetaminophen with narcotic analge...
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| Veröffentlicht in: | Journal of pediatric orthopaedics 2012-07, Vol.32 (5), p.452-455 |
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| container_title | Journal of pediatric orthopaedics |
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| creator | Swanson, Christopher E Chang, Kit Schleyer, Edward Pizzutillo, Peter D Herman, Martin J |
| description | BACKGROUND:Postoperative pain control in pediatric patients has become a priority for all institutions. There is a paucity of literature on pain control after orthopedic procedures in the pediatric population. The purpose of this study is to compare the efficacy of acetaminophen with narcotic analgesics, specifically, acetaminophen/codeine and morphine, for pain management after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children.
METHODS:We retrospectively evaluated 217 patients who received closed reduction and percutaneous pinning of type II or III supracondylar humerus fractures at our institution from 2003 to 2009. Hospital charts were reviewed to obtain demographic data. Patients were divided into narcotic and non-narcotic groups. The Oucher and FLACC scales were used to quantify the effectiveness of the pain control that was delivered.
RESULTS:A total of 174 patients were treated with non-narcotic pain medications and 43 patients received narcotics. The average age of these patients was 5.45 years. The mean postoperative pain score for the non-narcotic group was 1.9, whereas the mean postoperative pain score for the narcotic group was 2.2. This difference was not statistically significant. To account for the difference of age in patients and severity of fracture type, we created an age-matched cohort of patients with only type III supracondylar fractures. The average age of this group was 6.22 years. The mean pain score for the acetaminophen subgroup was 2.1 compared with a mean pain score of 2.4 for the narcotic subgroup. This difference was not statistically significant. Severe nausea or vomiting attributed to either class of medication was not observed. In addition, no patients developed a compartment syndrome.
CONCLUSIONS:Acetaminophen is as effective as narcotic analgesics for providing pain control after supracondylar fracture surgery in children and is historically associated with fewer side effects. It is our recommendation to use acetaminophen alone for postoperative pain control in these patients.
LEVEL OF EVIDENCE:III. |
| doi_str_mv | 10.1097/BPO.0b013e318259f85a |
| format | Article |
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METHODS:We retrospectively evaluated 217 patients who received closed reduction and percutaneous pinning of type II or III supracondylar humerus fractures at our institution from 2003 to 2009. Hospital charts were reviewed to obtain demographic data. Patients were divided into narcotic and non-narcotic groups. The Oucher and FLACC scales were used to quantify the effectiveness of the pain control that was delivered.
RESULTS:A total of 174 patients were treated with non-narcotic pain medications and 43 patients received narcotics. The average age of these patients was 5.45 years. The mean postoperative pain score for the non-narcotic group was 1.9, whereas the mean postoperative pain score for the narcotic group was 2.2. This difference was not statistically significant. To account for the difference of age in patients and severity of fracture type, we created an age-matched cohort of patients with only type III supracondylar fractures. The average age of this group was 6.22 years. The mean pain score for the acetaminophen subgroup was 2.1 compared with a mean pain score of 2.4 for the narcotic subgroup. This difference was not statistically significant. Severe nausea or vomiting attributed to either class of medication was not observed. In addition, no patients developed a compartment syndrome.
CONCLUSIONS:Acetaminophen is as effective as narcotic analgesics for providing pain control after supracondylar fracture surgery in children and is historically associated with fewer side effects. It is our recommendation to use acetaminophen alone for postoperative pain control in these patients.
LEVEL OF EVIDENCE:III.</description><identifier>ISSN: 0271-6798</identifier><identifier>EISSN: 1539-2570</identifier><identifier>DOI: 10.1097/BPO.0b013e318259f85a</identifier><identifier>PMID: 22706458</identifier><identifier>CODEN: JPORDO</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Acetaminophen - administration & dosage ; Acetaminophen - adverse effects ; Acetaminophen - therapeutic use ; Analgesics, Non-Narcotic - administration & dosage ; Analgesics, Non-Narcotic - adverse effects ; Analgesics, Non-Narcotic - therapeutic use ; Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - adverse effects ; Analgesics, Opioid - therapeutic use ; Biological and medical sciences ; Bone Nails ; Child ; Child, Preschool ; Codeine - administration & dosage ; Codeine - adverse effects ; Codeine - therapeutic use ; Cohort Studies ; Diseases of the osteoarticular system ; Drug Combinations ; Fracture Fixation - methods ; Humans ; Humeral Fractures - surgery ; Infant ; Injuries of the limb. Injuries of the spine ; Medical sciences ; Morphine - adverse effects ; Morphine - therapeutic use ; Pain Measurement ; Pain, Postoperative - drug therapy ; Retrospective Studies ; Traumas. Diseases due to physical agents ; Treatment Outcome</subject><ispartof>Journal of pediatric orthopaedics, 2012-07, Vol.32 (5), p.452-455</ispartof><rights>2012 Lippincott Williams & Wilkins, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4084-433203ff8f6e7e2a9b7221bf2ba451cdd1be6141b064e511e4594d6e81bb86393</citedby><cites>FETCH-LOGICAL-c4084-433203ff8f6e7e2a9b7221bf2ba451cdd1be6141b064e511e4594d6e81bb86393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26585661$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22706458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swanson, Christopher E</creatorcontrib><creatorcontrib>Chang, Kit</creatorcontrib><creatorcontrib>Schleyer, Edward</creatorcontrib><creatorcontrib>Pizzutillo, Peter D</creatorcontrib><creatorcontrib>Herman, Martin J</creatorcontrib><title>Postoperative Pain Control After Supracondylar Humerus Fracture Fixation</title><title>Journal of pediatric orthopaedics</title><addtitle>J Pediatr Orthop</addtitle><description>BACKGROUND:Postoperative pain control in pediatric patients has become a priority for all institutions. There is a paucity of literature on pain control after orthopedic procedures in the pediatric population. The purpose of this study is to compare the efficacy of acetaminophen with narcotic analgesics, specifically, acetaminophen/codeine and morphine, for pain management after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children.
METHODS:We retrospectively evaluated 217 patients who received closed reduction and percutaneous pinning of type II or III supracondylar humerus fractures at our institution from 2003 to 2009. Hospital charts were reviewed to obtain demographic data. Patients were divided into narcotic and non-narcotic groups. The Oucher and FLACC scales were used to quantify the effectiveness of the pain control that was delivered.
RESULTS:A total of 174 patients were treated with non-narcotic pain medications and 43 patients received narcotics. The average age of these patients was 5.45 years. The mean postoperative pain score for the non-narcotic group was 1.9, whereas the mean postoperative pain score for the narcotic group was 2.2. This difference was not statistically significant. To account for the difference of age in patients and severity of fracture type, we created an age-matched cohort of patients with only type III supracondylar fractures. The average age of this group was 6.22 years. The mean pain score for the acetaminophen subgroup was 2.1 compared with a mean pain score of 2.4 for the narcotic subgroup. This difference was not statistically significant. Severe nausea or vomiting attributed to either class of medication was not observed. In addition, no patients developed a compartment syndrome.
CONCLUSIONS:Acetaminophen is as effective as narcotic analgesics for providing pain control after supracondylar fracture surgery in children and is historically associated with fewer side effects. It is our recommendation to use acetaminophen alone for postoperative pain control in these patients.
LEVEL OF EVIDENCE:III.</description><subject>Acetaminophen - administration & dosage</subject><subject>Acetaminophen - adverse effects</subject><subject>Acetaminophen - therapeutic use</subject><subject>Analgesics, Non-Narcotic - administration & dosage</subject><subject>Analgesics, Non-Narcotic - adverse effects</subject><subject>Analgesics, Non-Narcotic - therapeutic use</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bone Nails</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Codeine - administration & dosage</subject><subject>Codeine - adverse effects</subject><subject>Codeine - therapeutic use</subject><subject>Cohort Studies</subject><subject>Diseases of the osteoarticular system</subject><subject>Drug Combinations</subject><subject>Fracture Fixation - methods</subject><subject>Humans</subject><subject>Humeral Fractures - surgery</subject><subject>Infant</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Medical sciences</subject><subject>Morphine - adverse effects</subject><subject>Morphine - therapeutic use</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Retrospective Studies</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><issn>0271-6798</issn><issn>1539-2570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1v1DAQhi0EokvhHyCUC1IvKTP-zrGsuixSpa7Uco6cZKwGvPFiJy399xh1oRIHy9boeT0zD2PvEc4RGvPp8-76HDpAQQItV423yr1gK1Siqbky8JKtgBustWnsCXuT83cANEKK1-yEcwNaKrti213MczxQcvN4T9XOjVO1jtOcYqgu_EypulkOyfVxGh6DS9V22VNacrUptXlJVG3GXyUap7fslXch07vjfcq-bS5v19v66vrL1_XFVd1LsLKWQnAQ3luvyRB3TWc4x87zzkmF_TBgRxoldmU-UogkVSMHTRa7zmrRiFN29vTvIcWfC-W53Y-5pxDcRHHJLQJH5KYsV1D5hPYp5pzIt4c07l16LFD7x2FbHLb_OyyxD8cOS7en4V_or7QCfDwCLvcu-OSmfszPnFZWaY3P_R9iKCbzj7A8UGrvyIX5rgXkEkVja15eYACgLgek-A055ooU</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Swanson, Christopher E</creator><creator>Chang, Kit</creator><creator>Schleyer, Edward</creator><creator>Pizzutillo, Peter D</creator><creator>Herman, Martin J</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201207</creationdate><title>Postoperative Pain Control After Supracondylar Humerus Fracture Fixation</title><author>Swanson, Christopher E ; Chang, Kit ; Schleyer, Edward ; Pizzutillo, Peter D ; Herman, Martin J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4084-433203ff8f6e7e2a9b7221bf2ba451cdd1be6141b064e511e4594d6e81bb86393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acetaminophen - administration & dosage</topic><topic>Acetaminophen - adverse effects</topic><topic>Acetaminophen - therapeutic use</topic><topic>Analgesics, Non-Narcotic - administration & dosage</topic><topic>Analgesics, Non-Narcotic - adverse effects</topic><topic>Analgesics, Non-Narcotic - therapeutic use</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bone Nails</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Codeine - administration & dosage</topic><topic>Codeine - adverse effects</topic><topic>Codeine - therapeutic use</topic><topic>Cohort Studies</topic><topic>Diseases of the osteoarticular system</topic><topic>Drug Combinations</topic><topic>Fracture Fixation - methods</topic><topic>Humans</topic><topic>Humeral Fractures - surgery</topic><topic>Infant</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Medical sciences</topic><topic>Morphine - adverse effects</topic><topic>Morphine - therapeutic use</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Retrospective Studies</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swanson, Christopher E</creatorcontrib><creatorcontrib>Chang, Kit</creatorcontrib><creatorcontrib>Schleyer, Edward</creatorcontrib><creatorcontrib>Pizzutillo, Peter D</creatorcontrib><creatorcontrib>Herman, Martin J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Swanson, Christopher E</au><au>Chang, Kit</au><au>Schleyer, Edward</au><au>Pizzutillo, Peter D</au><au>Herman, Martin J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Pain Control After Supracondylar Humerus Fracture Fixation</atitle><jtitle>Journal of pediatric orthopaedics</jtitle><addtitle>J Pediatr Orthop</addtitle><date>2012-07</date><risdate>2012</risdate><volume>32</volume><issue>5</issue><spage>452</spage><epage>455</epage><pages>452-455</pages><issn>0271-6798</issn><eissn>1539-2570</eissn><coden>JPORDO</coden><abstract>BACKGROUND:Postoperative pain control in pediatric patients has become a priority for all institutions. There is a paucity of literature on pain control after orthopedic procedures in the pediatric population. The purpose of this study is to compare the efficacy of acetaminophen with narcotic analgesics, specifically, acetaminophen/codeine and morphine, for pain management after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children.
METHODS:We retrospectively evaluated 217 patients who received closed reduction and percutaneous pinning of type II or III supracondylar humerus fractures at our institution from 2003 to 2009. Hospital charts were reviewed to obtain demographic data. Patients were divided into narcotic and non-narcotic groups. The Oucher and FLACC scales were used to quantify the effectiveness of the pain control that was delivered.
RESULTS:A total of 174 patients were treated with non-narcotic pain medications and 43 patients received narcotics. The average age of these patients was 5.45 years. The mean postoperative pain score for the non-narcotic group was 1.9, whereas the mean postoperative pain score for the narcotic group was 2.2. This difference was not statistically significant. To account for the difference of age in patients and severity of fracture type, we created an age-matched cohort of patients with only type III supracondylar fractures. The average age of this group was 6.22 years. The mean pain score for the acetaminophen subgroup was 2.1 compared with a mean pain score of 2.4 for the narcotic subgroup. This difference was not statistically significant. Severe nausea or vomiting attributed to either class of medication was not observed. In addition, no patients developed a compartment syndrome.
CONCLUSIONS:Acetaminophen is as effective as narcotic analgesics for providing pain control after supracondylar fracture surgery in children and is historically associated with fewer side effects. It is our recommendation to use acetaminophen alone for postoperative pain control in these patients.
LEVEL OF EVIDENCE:III.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>22706458</pmid><doi>10.1097/BPO.0b013e318259f85a</doi><tpages>4</tpages></addata></record> |
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| subjects | Acetaminophen - administration & dosage Acetaminophen - adverse effects Acetaminophen - therapeutic use Analgesics, Non-Narcotic - administration & dosage Analgesics, Non-Narcotic - adverse effects Analgesics, Non-Narcotic - therapeutic use Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Biological and medical sciences Bone Nails Child Child, Preschool Codeine - administration & dosage Codeine - adverse effects Codeine - therapeutic use Cohort Studies Diseases of the osteoarticular system Drug Combinations Fracture Fixation - methods Humans Humeral Fractures - surgery Infant Injuries of the limb. Injuries of the spine Medical sciences Morphine - adverse effects Morphine - therapeutic use Pain Measurement Pain, Postoperative - drug therapy Retrospective Studies Traumas. Diseases due to physical agents Treatment Outcome |
| title | Postoperative Pain Control After Supracondylar Humerus Fracture Fixation |
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