Epidural and intravenous bolus morphine for postoperative analgesia in infants

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
C M HaberkernM Pomietto

Abstract

To compare two doses of bolus epidural morphine with bolus iv morphine for postoperative pain after abdominal or genitourinary surgery in infants. Eighteen infants were randomly assigned to bolus epidural morphine (0.025 mg.kg-1 or 0.050 mg.kg-1) or bolus iv morphine (0.050-0.150 mg.kg-1). Postoperative pain was assessed and analgesia provided, using a modified infant pain scale. Monitoring included continuous ECG, pulse oximetry, impedance and nasal thermistor pneumography. The CO2 response curves and serum morphine concentrations were measured postoperatively. Postoperative analgesia was provided within five minutes by all treatment methods. Epidural groups required fewer morphine doses (3.8 +/- 0.8 for low dose [LE], 3.5 +/- 0.8 for high dose epidural [HE] vs. 6.7 +/- 1.6 for iv, P < 0.05) and less total morphine (0.11 +/- 0.04 mg.kg-1 for LE, 0.16 +/- 0.04 for HE vs 0.67 +/- 0.34 for iv, P < 0.05) on POD1. Dose changes were necessary in all groups for satisfactory pain scores. Pruritus, apnoea, and haemoglobin desaturation occurred in all groups. CO2 response curve slopes, similar preoperatively (range 36-41 ml.min-1.mmHg ETCO2-1.kg-1) were generally depressed (range, 16-27 ml.min-1.mmHg ETCO2-1.kg-1) on POD1. Serum morphin...Continue Reading

References

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Citations

Sep 21, 2001·Indian Journal of Pediatrics·M Yaster, D G Nichols
Nov 7, 2001·Paediatric Anaesthesia·S Suresh, K J Anand
Apr 21, 2010·Pediatrics·Kanwaljeet J S AnandUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Resear
Jan 20, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·O Gall, UNKNOWN Comité douleur-anesthésie locorégionale et le comité des référentiels de la Sfar
Dec 19, 2006·Annales Françaises D'anesthèsie Et De Rèanimation·C Dadure, X Capdevila
Nov 5, 2011·Paediatric Anaesthesia·Christophe Dadure, Xavier Capdevila
Aug 25, 2005·Clinical Therapeutics·K J S AnandGary A Walco
Jun 13, 2002·Acta Anaesthesiologica Scandinavica·L JylliG L Olsson
Dec 21, 2005·The Journal of Bone and Joint Surgery. British Volume·J E GordonE C Uong

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