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Eur J Pediatr Surg 2016; 26(06): 469-475
DOI: 10.1055/s-0036-1582243
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Intraperitoneal Local Anesthetic in Pediatric Surgery: A Systematic Review

James K. Hamill
1   Department of Paediatric Surgery and Urology, Starship Children's Hospital, Auckland, New Zealand
,
Jamie-Lee Rahiri
2   Department of Surgery, University of Auckland, Auckland, New Zealand
,
Andrew Liley
3   Department of Anaesthesia, Starship Children's Health, Auckland, New Zealand
,
Andrew G. Hill
2   Department of Surgery, University of Auckland, Auckland, New Zealand
› Author Affiliations
Further Information

Publication History

05 January 2016

26 February 2016

Publication Date:
22 April 2016 (online)

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Abstract

Introduction Systematic reviews report intraperitoneal local anesthetic (IPLA) effective in adults but until now no review has addressed IPLA in children. The objective of this review was to answer the question, does IPLA compared with control reduce pain after pediatric abdominal surgery.

Materials and Methods Data sources: MEDLINE, EMBASE, Cochrane databases, trials registries, ProQuest, Web of Science, Google Scholar, and Open Gray. Study selection: Independent duplicate searching for randomized controlled trials of IPLA versus no IPLA/placebo in children ≤ 18 years of age, reporting pain, or opioid use outcomes. Data extraction: Independent duplicate data extraction and quality assessment using standardized fields.

Results The selection process uncovered three eligible published trials and one unpublished study, all in laparoscopy surgery. Qualitative synthesis suggested that IPLA may reduce pain scores, opioid use, time to first opioid, and the need for rescue analgesia, with no effect on hospital stay. Risk of bias was significant.

Conclusions IPLA appears promising in pediatric surgery. The high absorptive capacity of the peritoneum and high peritoneal surface area to volume ratio in children presents a dose limitation. In comparison to adult surgery, IPLA has been understudied in pediatric surgery.

Keywords

child - postoperative pain - laparoscopy - local anesthetics - pain management

Supplementary Material

 

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