Peridural catheter for postoperative long-term analgesia in children

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
K BoosW Ohrdorf

Abstract

Continuous epidural anaesthesia is a well established procedure for postoperative analgesia as well as sympathicolysis in adult patients. It is, however, much less frequently reported in infants and children. From October 1991 to November 1994 65 infants, children and adolescents aged 4 weeks to 19 years, body weight 3.9 kg to 79 kg, received 77 epidural catheters for postoperative analgesia. 54 catheters were inserted via the caudal approach either with (n = 19) or without (n = 35) subcutaneous tunnelling. 23 catheters were placed via a low midline lumbar epidural puncture either through interspace L5/S1 or L4/L5. The local anaesthetic of choice in this study was bupivacaine 0.125% without adrenaline infused continuously via a constant-flow infusion pump. 20 patients received additional boluses of morphine and in 3 patients clonidine was added. The catheters were left in place for an average of 84.5 h. After removal the catheter-tip was submitted for bacteriological examination. The results of 64 specimens were available. For satisfactory analgesia an average of 0.18 mg x kg-1 x h-1 bupivacaine 0.125% had to be administered via the lumbar route, while the mean dose for caudal catheters was 0.3 mg x kg-1 x h-1. Intestinal peris...Continue Reading

Citations

Mar 15, 2002·Anesthesiology Clinics of North America·Sabine Kost-Byerly
Mar 29, 2000·Paediatric Anaesthesia·L VasS Sanzgiri
Oct 5, 2006·Current Opinion in Anaesthesiology·Christian Seefelder

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