PMID- 37691705
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230913
IS  - 2169-7574 (Print)
IS  - 2169-7574 (Electronic)
IS  - 2169-7574 (Linking)
VI  - 11
IP  - 9
DP  - 2023 Sep
TI  - Opioid-free Pain Management after Cleft Lip Repair.
PG  - e5259
LID - 10.1097/GOX.0000000000005259 [doi]
LID - e5259
AB  - BACKGROUND: Side effects of opioid pain management after surgical repair of cleft 
      lips are numerous and affect postoperative course. We compared opioid versus 
      opioid-free pain management regimens for infants who underwent cleft lip repair 
      to evaluate the impact on postoperative recovery. METHODS: Cleft lip repairs at 
      our institution from December 2016 to February 2021 were retrospectively 
      reviewed, comparing patients who received opioids to patients receiving a 
      nonopioid pain control regimen. Data collected include length of stay, oral 
      morphine equivalents (OME) received on day of surgery (DOS)/postoperative day 
      (POD) 1, time to and volume of first oral feed, and 
      Face/Legs/Activity/Cry/Consolability (FLACC) scores. RESULTS: Seventy-three 
      infants were included (47 opioid and 26 nonopioid). The opioid group received 
      average 1.75 mg OME on DOS and 1.04 mg OME on POD1. Average DOS FLACC scores were 
      similar between groups [1.57 +/- 1.18 nonopioid versus 1.76 +/- 0.94 (SD) opioid; P = 
      0.46]. Average POD1 FLACC scores were significantly lower for the nonopioid group 
      (0.73 +/- 1.05 versus 1.35 +/- 1.06; P = 0.022). Median time to first PO (min) was 
      similar [178 (interquartile range [IQR] 66-411) opioid versus 147 (IQR 93-351) 
      nonopioid; P = 0.65]. Median volume of first feed (mL) was twice as high for the 
      nonopioid group [90 (IQR 58-120) versus 45 (IQR 30-60); P = 0.003]. CONCLUSIONS: 
      Nonopioid postoperative pain management was more effective than opioids for pain 
      management in infants after cleft lip repair, as evidenced by FLACC scores and 
      increased volume of the first oral feed.
CI  - Copyright (c) 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf 
      of The American Society of Plastic Surgeons.
FAU - Do, Annie
AU  - Do A
AD  - From the Division of Plastic & Reconstructive Surgery, Department of Surgery, 
      University of California San Francisco; San Francisco, Calif.
FAU - Rorison, Eve
AU  - Rorison E
AD  - From the Division of Plastic & Reconstructive Surgery, Department of Surgery, 
      University of California San Francisco; San Francisco, Calif.
FAU - Borucki, Amber
AU  - Borucki A
AD  - Department of Anesthesia, University of California San Francisco; San Francisco, 
      Calif.
FAU - Shibata, Gail S
AU  - Shibata GS
AD  - Department of Anesthesia, University of California San Francisco; San Francisco, 
      Calif.
FAU - Pomerantz, Jason H
AU  - Pomerantz JH
AD  - From the Division of Plastic & Reconstructive Surgery, Department of Surgery, 
      University of California San Francisco; San Francisco, Calif.
FAU - Hoffman, William Y
AU  - Hoffman WY
AD  - From the Division of Plastic & Reconstructive Surgery, Department of Surgery, 
      University of California San Francisco; San Francisco, Calif.
LA  - eng
PT  - Journal Article
DEP - 20230908
PL  - United States
TA  - Plast Reconstr Surg Glob Open
JT  - Plastic and reconstructive surgery. Global open
JID - 101622231
PMC - PMC10489184
COIS- The authors have no financial interest to declare in relation to the content of 
      this article.
EDAT- 2023/09/11 06:42
MHDA- 2023/09/11 06:43
PMCR- 2023/09/08
CRDT- 2023/09/11 04:25
PHST- 2023/07/06 00:00 [received]
PHST- 2023/07/21 00:00 [accepted]
PHST- 2023/09/11 06:43 [medline]
PHST- 2023/09/11 06:42 [pubmed]
PHST- 2023/09/11 04:25 [entrez]
PHST- 2023/09/08 00:00 [pmc-release]
AID - 10.1097/GOX.0000000000005259 [doi]
PST - epublish
SO  - Plast Reconstr Surg Glob Open. 2023 Sep 8;11(9):e5259. doi: 
      10.1097/GOX.0000000000005259. eCollection 2023 Sep.