Postoperative morphine consumption in children with sickle‐cell disease
Bibliographic record
Abstract
BACKGROUND: Effective pain control is a primary goal in the perioperative management of patients with sickle-cell disease. To understand analgesic requirements better, the authors compared postoperative morphine consumption and pain scores in sickle and non-sickle children who had undergone laparoscopic cholecystectomy. METHODS: We reviewed the medical records of all sickle and non-sickle children referred to the Acute Pain Service of a tertiary care teaching hospital for patient-controlled analgesia (PCA) following laparoscopic cholecystectomy from 1996 to 2003. Data collected included postoperative morphine consumption, visual analogue pain scores, and perioperative outcome. RESULTS: Total postoperative morphine consumption in sickle children (n = 12) (1.58 +/- 0.78 mg.kg(-1)) was more than double when compared with non-sickle children (n = 10) (0.65 +/- 0.32 mg.kg(-1)) (P < 0.005). Duration of PCA use among sickle children (51 +/- 25 h) was more than double when compared with non-sickle children (21 +/- 11 h) (P < 0.005). Sickle patients had greater pain scores in the initial 24 h after surgery (P < 0.05) and used more adjuvant analgesics (P < 0.05). Duration of postoperative hospital stay was 3.4 +/- 1.6 days and 1.5 +/- 0.5 days for sickle and non-sickle children, respectively (P < 0.005). CONCLUSIONS: Sickle children self-administered more than double the amount of morphine, reported more intense pain, and remained hospitalized for more than twice as long as nonsickle children undergoing the same surgical procedure. These findings probably have a multifactorial origin, and might be attributable in part to alterations in pain perception, opioid pharmacokinetics, opioid tolerance, and psychosocial variables.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".