Effectiveness of morphine via thoracic epidural vs intravenous infusion on postthoracotomy pain and stress response in children

Paediatric Anaesthesia
Pervin BozkurtMois Bahar

Abstract

Thoracotomy causes severe pain in the postoperative period. The aim was to evaluate effectiveness of two pain treatment methods with morphine on postthoracotomy pain and stress response. Thirty-two children undergoing major thoracotomy for noncardiac thoracic surgery were allocated to receive either single dose of thoracic epidural morphine 0.1 mg x kg(-1) in 0.2 ml x kg(-1) saline (TEP group, n = 16) or morphine infusion at 0.02 mg x kg(-1) h(-1) (INF group, n = 16) following bolus dose of 0.05 mg x kg(-1) postinduction. Pain and sedation scores and incidence of complications were recorded for 24 h and cortisol, blood glucose, insulin and morphine serum levels were evaluated following induction, 1, 8, 12, and 24 h after initial morphine administration. Five patients in TEP and one in INF required rescue morphine. The cortisol, insulin and blood glucose increased during the study and returned to normal levels at 24th hour (P < 0.05), similarly in both groups (P > 0.05). The morphine levels were variable within and between groups (P < 0.05). A common complication was nausea and vomiting with both the techniques (P > 0.05). Single dose TEP morphine offers no advantage over INF for pain treatment for thoracotomy in children and ne...Continue Reading

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Citations

Jan 28, 2009·Applied Nursing Research : ANR·Ann Marie McCarthyEva Tsalikian
Sep 9, 2005·Acta Anaesthesiologica Scandinavica·P BozkurtY Yeker
May 28, 2008·Paediatric Anaesthesia·Richard HowardUNKNOWN Association of Paediatric Anaesthetists of Great Britain and Ireland
Apr 23, 2015·Regional Anesthesia and Pain Medicine·Andrew D FranklinCurtis A Wushensky
Jun 28, 2006·Southern Medical Journal·Dawn D Smiley, Guillermo E Umpierrez
Jan 25, 2011·Expert Opinion on Pharmacotherapy·Wai Yin MakTheresa Hui

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