TY - JOUR
KW - Airway Extubation
KW - Anesthesia, General/adverse effects
KW - Case-Control Studies
KW - Child
KW - Female
KW - Humans
KW - Male
KW - Naloxone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Postoperative Period
KW - Respiratory Insufficiency/drug therapy
KW - Retrospective Studies
KW - Analgesics
KW - General anesthesia
KW - Hypoventilation
KW - Narcotic Antagonists
KW - Postoperative complications
KW - Surgery
AU - Vinay K. Donempudi
AU - Juraj Sprung
AU - Toby N. Weingarten
A1 - 
AB - PURPOSE: Excessive narcotization in pediatric surgical patients has not been well characterized. This report describes the use of postoperative naloxone in pediatric patients. METHODS: Pediatric surgical patients from January 1, 2010, through June 30, 2016, who underwent general anesthesia and received naloxone within 48 h postoperatively were identified and matched 1:1 with controls by age, sex, and procedure. Cases and controls underwent retrospective chart review. RESULTS: Forty-seven patients received naloxone, with a rate of 2.0 (95% CI 1.5-2.7) per 1000 anesthetics. Indications were respiratory depression (n = 19), facilitating extubation (n = 15), and reversing sedation (n = 13), and 44 cases received naloxone in a monitored environment. The median (interquartile range) naloxone dose was 4.0 (2.0-23.5) mcg/kg, and five patients (11%) later required subsequent naloxone treatments. Their characteristics were similar to controls, including opioid medications, except cases that had signs of respiratory depression before naloxone administration. The outcomes were similar, although more cases were admitted to the intensive care unit before naloxone administration. One patient died 13 days postoperatively of unrelated causes. CONCLUSION: Postoperative naloxone administration in pediatric patients is rare. The observation that most administrations occurred in a monitored setting implies that at-risk patients had been appropriately identified and kept under closer surveillance.
AD - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. weingarten.toby@mayo.edu.
BT - Pediatric surgery international
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 3
CY - Germany
DO - 10.1007/s00383-017-4212-2
IS - 3
JF - Pediatric surgery international
LA - eng
M1 - Journal Article
N2 - PURPOSE: Excessive narcotization in pediatric surgical patients has not been well characterized. This report describes the use of postoperative naloxone in pediatric patients. METHODS: Pediatric surgical patients from January 1, 2010, through June 30, 2016, who underwent general anesthesia and received naloxone within 48 h postoperatively were identified and matched 1:1 with controls by age, sex, and procedure. Cases and controls underwent retrospective chart review. RESULTS: Forty-seven patients received naloxone, with a rate of 2.0 (95% CI 1.5-2.7) per 1000 anesthetics. Indications were respiratory depression (n = 19), facilitating extubation (n = 15), and reversing sedation (n = 13), and 44 cases received naloxone in a monitored environment. The median (interquartile range) naloxone dose was 4.0 (2.0-23.5) mcg/kg, and five patients (11%) later required subsequent naloxone treatments. Their characteristics were similar to controls, including opioid medications, except cases that had signs of respiratory depression before naloxone administration. The outcomes were similar, although more cases were admitted to the intensive care unit before naloxone administration. One patient died 13 days postoperatively of unrelated causes. CONCLUSION: Postoperative naloxone administration in pediatric patients is rare. The observation that most administrations occurred in a monitored setting implies that at-risk patients had been appropriately identified and kept under closer surveillance.
PP - Germany
PY - 2018
SN - 1437-9813; 0179-0358
SP - 335
EP - 341
EP - 
T1 - Pediatric patients receiving naloxone within 48 h of anesthesia: a case-control study
T2 - Pediatric surgery international
TI - Pediatric patients receiving naloxone within 48 h of anesthesia: a case-control study
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 29124404
U3 - 10.1007/s00383-017-4212-2
VL - 34
VO - 1437-9813; 0179-0358
Y1 - 2018
Y2 - Mar
ER -