{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:07:24Z","timestamp":1776283644607,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":85,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010564","name":"Academic Medical Organization of Southwestern Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002724","name":"Child Health Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002724","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    A quality improvement initiative was developed, implemented, and evaluated to improve pediatric postsurgical pain management and reduce hospital length of stay.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    An interdisciplinary working group developed the novel integrated pediatric perioperative pain (IP3) pathway adhering to the 3P approach to pain management. Preoperative psychological intervention, patient and caregiver education, standardized medication ordersets, and early identification of increased pain were the focus. Length of stay, opioid consumption, and achievement of physiotherapy goals were compared pre\u2010 and postpathway for children undergoing posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The prepathway (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200934) and postpathway (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200929) groups were well matched for age, gender, weight, number of levels fused, and socioeconomic status. Postpathway, length of stay in the intensive care unit (pre 1.06\u2009days and post 0.76\u2009days,\n                    <jats:italic>p<\/jats:italic>\n                    \u2264 0.01) and length of hospital stay (pre 6.24\u2009days and post 5.11\u2009days,\n                    <jats:italic>p<\/jats:italic>\n                    \u2264 0.01) significantly decreased. Standardized physiotherapy goals were achieved earlier postpathway implementation. Day of surgery postoperative opioid consumption was reduced in the postpathway group.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Discussion:<\/jats:bold>\n                    Implementation of the IP3 pathway resulted in significant improvement in pain management for children undergoing major orthopedic surgery. Shortened hospital stay, earlier achievement of physiotherapy goals, and reduced initial opioid consumption were realized. Future efforts will focus on applying this pathway to other pediatric surgeries, optimizing surgical scheduling, and enhancing staff education.\n                  <\/jats:p>","DOI":"10.1155\/anrp\/8014510","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T06:52:39Z","timestamp":1743058359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Implementation of an Integrated Pediatric Perioperative Pain Pathway: A Quality Improvement Initiative"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2135-2082","authenticated-orcid":false,"given":"Brynn P.","family":"Charron","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5716-6074","authenticated-orcid":false,"given":"Niveditha","family":"Karuppiah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5630-5124","authenticated-orcid":false,"given":"Ushma","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Katchky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7691-0962","authenticated-orcid":false,"given":"Raju","family":"Poolacherla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S40846"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12420"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13061266"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.4097\/kja.d.18.00217"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01095"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-16-00049"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003143"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2023.2254185"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_51_18"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219858308"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0000000000000167"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000671"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-020-00423-1"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000616"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2017.03.007"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen099"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.20"},{"key":"e_1_2_15_18_2","unstructured":"Census Profile-2021 Census of Population. 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