• Elizabeth R Vogel, Steven J Staffa, James A DiNardo, and Morgan L Brown.
• Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA.
• J. Cardiothorac. Vasc. Anesth. 2022 Jan 1; 36 (1): 195-199.

ObjectiveTo determine whether children with Down syndrome (DS) receive higher doses of opioid medications compared with children without DS for repair of complete atrioventricular canal (CAVC).DesignA retrospective chart review of children with and without DS who underwent primary repair of CAVC. The exclusion criteria included unbalanced CAVC and patients undergoing biventricular staging procedures. The primary outcome was oral morphine equivalents (OME) received in the first 24 hours after surgery. The secondary outcomes included intraoperative OME, OME at 48 and 72 hours, nonopioid analgesic and sedative medications received, pain scores, time to extubation, and length of stay.SettingA pediatric academic medical center in the United States.ParticipantsOne hundred thirty-one patients with DS and 24 without, all InterventionsNot applicable.Measurements And Main ResultsPatients with DS were older than patients without DS (median 96.3 days [interquartile range {IQR} 70.7-128.2] v 75.9 days [IQR 49.8-107.3], p = 0.033) but otherwise not statistically different in the baseline characteristics. There was no difference in OME received in the first 24 hours postoperatively between groups (3.01 mg/kg [IQR 1.23-5.43] v 3.57 mg/kg [IQR 1.54-7.06], p = 0.202). OME at 48 and 72 hours was lower in the DS group compared with the control group. Similar amounts of opioid and non-opioid analgesics and sedatives were otherwise given to both groups of patients. Median pain scores did not differ between groups.ConclusionsThese results suggested that patients with DS undergoing CAVC repair do not have increased opioid requirements compared with a similar control group.Copyright © 2021 Elsevier Inc. All rights reserved.

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