Postoperative Pain Management in Pediatric Patients Undergoing Cardiac Surgery: Where Are We Heading?

Uri Pollak; Ronald A Bronicki; Barbara-Jo Achuff; Paul A Checchia

doi:10.1177/0885066619871432

Postoperative Pain Management in Pediatric Patients Undergoing Cardiac Surgery: Where Are We Heading?

J Intensive Care Med. 2019 Aug 25:885066619871432. doi: 10.1177/0885066619871432. Online ahead of print.

Authors

Uri Pollak^{1

2

3

4}, Ronald A Bronicki^{5

6}, Barbara-Jo Achuff^{5

6}, Paul A Checchia^{5

6}

Affiliations

¹ 1 Pediatric Cardiac Critical Care Unit, Hadassah University Medical Center, Ein Kerem, Jerusalem, Israel.
² 2 Pediatric Cardiology, Hadassah University Medical Center, Ein Kerem, Jerusalem, Israel.
³ 3 Pediatric Extracorporeal Support Program, Hadassah University Medical Center, Ein Kerem, Jerusalem, Israel.
⁴ 4 The Hebrew University Hadassah Medical School, Jerusalem, Israel.
⁵ 5 Department of Pediatrics, Critical Care Medicine and Cardiology, Baylor College of Medicine, Houston, TX, USA.
⁶ 6 Pediatric Cardiovascular Intensive Care Unit, Texas Children's Hospital, Houston, TX, USA.

PMID: 31446831
DOI: 10.1177/0885066619871432

Abstract

Objectives: Adequate postoperative pain management is crucial in pediatric patients undergoing cardiac surgery because pain can lead to devastating short- and long-term consequences. This review discusses the limitations of current postoperative pain assessment and management in children after cardiac surgery, the obstacles to providing optimal treatment, and concepts to consider that may overcome these barriers.

Data source: MEDLINE and PubMed.

Conclusions: Effective pain management in infants and young children undergoing cardiac surgery continues to evolve with innovative methods of both assessment and therapy using newer drugs or novel routes of administration. Artificial intelligence- and machine learning-based pain assessment and patient-tailored management in both pain measurement and prevention are already being integrated into the routine of current practice.

Keywords: analgesia; congenital heart defect; pain; pediatric cardiac surgery; postoperative care.