Efficacy of continuous epidural analgesia versus single dose caudal analgesia in children after intravesical ureteroneocystostomy

The Journal of Urology
Paul A MerguerianBarry Chang

Abstract

We compared the effects of single dose caudal injection and continuous epidural infusion of bupivacaine on postoperative pain intensity and supplemental opioid analgesic requirements in children undergoing intravesical ureteroneocystostomy. Children 6 to 18 years old scheduled for ureteroneocystostomy were recruited for the study. Patients were randomized to group 1--caudal injection of 0.25% bupivacaine before approximately surgical incision and group 2--placement of an epidural catheter with injection of 0.25% bupivacaine, followed by a continuous epidural infusion upon completion of surgery. All patients received intravenous morphine patient controlled analgesic (PCA) as a rescue analgesic, and ketorolac and oxybutynin postoperatively. The epidural catheter was discontinued 48 hours after surgery, with removal of the urinary drainage catheter 4 hours later. Outcome measures included pain intensity rating, supplemental morphine requirements, presence and pain intensity of bladder spasms, analgesia related side effects, time to tolerating a regular diet, and patient and parent satisfaction. There was no statistically significant difference in average daily pain scores between the 2 groups. In the postanesthesia care unit. Sign...Continue Reading

References

Aug 1, 1995·The Journal of Urology·M P CainS A Kramer
Jun 1, 1997·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·M ConchaR Molina
Oct 5, 2001·The Journal of Urology·R D ChauhanH N Noe
Feb 4, 2003·Paediatric Anaesthesia·George Chalkiadis
Sep 3, 2003·Paediatric Anaesthesia·Mark AnserminoCarolyne Montgomery

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Citations

Oct 22, 2013·Urology·Kasey MorrisonC D Anthony Herndon
Aug 24, 2013·Journal of the American College of Surgeons·Martin L BlakelyUNKNOWN Pediatric Surgery Research Collaborative
Jul 25, 2009·The Journal of Urology·Karim ChamieEric A Kurzrock

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