title: Efficacy of scheduled nonnarcotic analgesic medications in children after suboccipital craniectomy.
abstract: OBJECTIVE
  The authors performed a study to evaluate the efficacy of a regimen of scheduled minor analgesic medications in managing postoperative pain in children undergoing intracranial procedures.
  
  
  METHODS
  Postoperative pain scores were analyzed in two groups of children who underwent decompressive surgery for Chiari malformation: Group A underwent a scheduled regimen of minor oral analgesic medications (standing doses of acetaminophen [10 mg/kg] and ibuprofen [10 mg/kg] alternating every 2 hours) and Group B received analgesic medication when requested. Fifty children underwent a standard occipital craniectomy (25 in each group). The pain scores were significantly lower in Group A during most of the postoperative period. Length of stay (LOS) was shorter (2.2 compared with 2.8 days), and narcotic and antiemetic requirements were also lower in Group A patients than in Group B patients. Patients with spinal cord syringes exhibited a similar postoperative status to those without, and similar improvements in pain scores with scheduled minor analgesic medications were also evident.
  
  
  CONCLUSIONS
  A regimen of minor analgesic therapy, given in alternating doses every 2 hours immediately after craniotomy and throughout hospitalization, significantly reduced postoperative pain scores and LOS in children in whom suboccipital craniotomy was performed. Narcotic and antiemetic requirements were also decreased in association with this regimen. Application of this postoperative analgesia protocol may benefit children and adults in whom various similar neurosurgical procedures are required.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital of Alabama, Birmingham, Alabama 35233, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Smyth
authors.forename: Jason T
authors.initials: JT
authors.lastname: Banks
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: John C
authors.initials: JC
authors.lastname: Wellons
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D001139:Arnold-Chiari Malformation / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D019299:Decompression, Surgical; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000009:adverse effects; D007796:Laminectomy; D007902:Length of Stay; D008297:Male; D009777:Occipital Bone / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000700:Analgesics; D000082:Acetaminophen; D007052:Ibuprofen