Epidural Analgesia for Postoperative Pain Control in Children

• Published in: Journal of pediatric orthopaedics Vol. 18; no. 4; pp. 492 - 496
• Main Authors: Jones, Marci D, Aronsson, David D, Harkins, Jean M, Smail, David F, Haugh, Larry D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01-07-1998; Lippincott
• Subjects: Adjuvants, Anesthesia - administration & dosage; Adolescent; Analgesia, Epidural - methods; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Local - administration & dosage; Biological and medical sciences; Bupivacaine - administration & dosage; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Fentanyl - administration & dosage; Humans; Infant; Length of Stay; Local anesthesia. Pain (treatment); Male; Medical sciences; Pain Measurement; Pain, Postoperative - drug therapy; Prognosis; Treatment Outcome; Human; Postoperative; Indication; Treatment efficiency; Fentanyl; Morphine; Extradural; Analgesia; Chemotherapy; Bupivacaine; Pain; Treatment; Surgery; Anesthesia; Child; Anilide
• ISSN: 0271-6798; 1539-2570
• DOI: 10.1097/01241398-199807000-00018

Ninety-eight continuous postoperative epidurals were administered to 87 children. The patients were divided into two groupsgroup 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 μg 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.