Epidural analgesia for postoperative pain control in children

Epidural analgesia for postoperative pain control in children

Jones MD; Aronsson DD; Harkins JM; Smail DF; Haugh LD

Journal Of Pediatric Orthopedics

1998

Child; Female; Humans; Male; Pain; Pain Measurement; Prognosis; Treatment Outcome; Drug Therapy; Length of Stay; Analgesia; Anesthetics; adolescent; Preschool; infant; Comparative Study; Dose-Response Relationship; Drug; Fentanyl/administration & dosage; Adjuvants; Postoperative/drug therapy; Combination; Anesthesia/administration & dosage; Bupivacaine/administration & dosage; Epidural/methods; Local/administration & dosage

Ninety-eight continuous postoperative epidurals were administered to 87 children. The patients were divided into two groups: group I included 63 cases in which a 0.0625-0.25% solution of bupivacaine was continuously administered; group II included 35 cases in which a similar solution of bupivacaine mixed with 2-10 micrograms of fentanyl was administered. The dose of the epidural medication was titrated by the anesthesiologist according to the patient's age and anticipated level of postoperative pain. The average pain score for all patients for the first 48 h was 1.43. Supplemental analgesia averaging 0.132 mg intravenous morphine/kg/8 h was required in 49 cases (41 in group I and eight in group II). In group I, the average dose of supplemental analgesia was 0.144 mg intravenous morphine/kg/8 h, whereas in group II, it was only 0.056 mg intravenous morphine/kg/8 h. Continuous epidural analgesia is effective in controlling postoperative pain, and the addition of fentanyl reduces the need for systemic narcotics.

1998

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