Abstract
Background: Postoperative wound pain is commonly observed in the pediatric postanesthesia care unit (PACU) following tonsillectomy, adenoidectomy, and adenotonsillectomy (adeno/tonsillectomy), which contributes to increased medical care costs and delayed facility discharge. The purpose of this study was to review the benefits of preoperative administration of Hycet elixir (2.5 mg hydrocodone and 108 mg acetaminophen per 5 mL) in a pediatric population aged 1 to 9 years following adeno/tonsillectomy.Methods: Patient demographics, comorbidities, surgical and anesthetic times, need for postoperative rescue therapies, and PACU recovery and length of stay times were measured in pediatric patients who received preoperative administration of Hycet elixir (0.2 mg/kg hydrocodone) for adeno/tonsillectomy in an outpatient setting compared to a control group.Results: The Hycet elixir group had significant reductions in PACU and hospital lengths of stay and significant reductions in the need for postoperative rescue analgesics. No significant differences were observed in emergence times or in the incidences of unplanned hospital admission between the control and Hycet elixir groups.Conclusion: These data show that the preoperative administration of Hycet elixir is well tolerated in the pediatric patient population undergoing adeno/tonsillectomy and appears to significantly reduce the need for postoperative rescue analgesics and postoperative care times. These data support the use of preoperative administration of Hycet elixir in this patient population.
Highlights
A higher percentage of American Society of Anesthesiologists Physical Status (ASA PS) I patients was observed in the control group, with a higher percentage of ASA PS II patients observed in the Hycet elixir group
Patients in the Hycet elixir group had clinically significant reductions in postanesthesia care unit (PACU) length of stay and hospital length of stay compared to patients in the control group
The findings suggest that preoperative administration of the multimodal analgesic Hycet elixir provides postoperative benefits by decreasing the need for rescue analgesics and supportive help in the PACU
Summary
Postoperative wound pain is commonly observed in the postanesthesia care unit (PACU) following tonsillectomy, adenoidectomy, and adenotonsillectomy (adeno/ tonsillectomy).[1,2,3] Postoperative pain contributes to development of emergence delirium after general anesthesia,[2,3,4,5] with attendant risk of self-injury, requiring additional nursing staff for management and resulting in increases in medical care costs, delays in patient discharge, and decreases in patient and care provider satisfaction scores.[2,3,4] Intraoperative administration of short-acting opiates, such as fentanyl, remifentanil, or sufentanil; nonsteroidal drugs; or dexmedetomidine to ameliorate the incidence of postoperative wound pain has been used with varying results.[5,6,7,8,9] postoperative administration of Hycet elixir, a commonly administered, longer-acting, hydrocodone/acetaminophen analgesic preparation, is prescribed in our pediatric PACU for control of postoperative pain. The purpose of this study was to review the benefits, if any, of preoperative administration of Hycet elixir on the need for rescue therapies for postoperative wound pain, postoperative nausea and vomiting, and emergence delirium, as well as the durations of PACU and hospital lengths of stay in children undergoing adeno/tonsillectomy. Methods: Patient demographics, comorbidities, surgical and anesthetic times, need for postoperative rescue therapies, and PACU recovery and length of stay times were measured in pediatric patients who received preoperative administration of Hycet elixir (0.2 mg/kg hydrocodone) for adeno/tonsillectomy in an outpatient setting compared to a control group. Conclusion: These data show that the preoperative administration of Hycet elixir is well tolerated in the pediatric patient population undergoing adeno/tonsillectomy and appears to significantly reduce the need for postoperative rescue analgesics and postoperative care times. These data support the use of preoperative administration of Hycet elixir in this patient population
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