Postoperative continuous intrathecal pain treatment in children after selective dorsal rhizotomy with bupivacaine and two different morphine doses

Paediatric Anaesthesia
K HesselgardP Reinstrup

Abstract

Children undergoing selective dorsal rhizotomy (SDR) experience severe pain postoperatively; a pain related to both the extensive surgical exposure with multilevel laminectomy and nerve root manipulation. We sought to define an optimal dose of continuous intrathecal (IT) morphine and bupivacaine to treat this severe pain. The aim of this study was to compare two different concentrations of morphine in a fixed dose of bupivacaine with regard to the analgesic effect and survey if they differed in side effects. Twenty-six children, aged 2.7-7.4 years undergoing SDR were included in this study. Postoperatively 11 children received a continuous infusion of morphine 0.4 microg x kg(-1) x h(-1) and bupivacaine 40 microg x kg(-1) x h(-1) (low-dose group) and 15, a continuous infusion of morphine 0.6 microg x kg(-1) x h(-1) and bupivacaine 40 microg x kg(-1) x h(-1) (high-dose group). The Behavioral Observational Pain Scale (BOPS) was used to evaluate pain. Better pain relief was obtained in the high-dose group seen in lower BOPS score compared with the low-dose group [P = 0.03, Fisher's permutation test and P = 0.06 Wilcoxon-Mann-Whitney (WMW) test]. The low-dose group received seven times as much ketobemidone 0.43 +/- 0.54 mg x kg(-1)...Continue Reading

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Citations

Jun 15, 2007·Journal of Neurosurgery·R Shane TubbsW Jerry Oakes
Aug 21, 2012·Anesthesiology Clinics·Lawrence T LaiAudrée A Bendo
Dec 24, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Deniz KonyaMemet M Ozek
Sep 22, 2007·Anesthesiology Clinics·Jose Ortiz-Cardona, Audrée A Bendo
Oct 24, 2007·Peptides·Richard J Bodnar
Oct 28, 2011·Regional Anesthesia and Pain Medicine·Sonal SharmaMarcel E Durieux
Jun 9, 2009·Anaesthesia and Intensive Care·A McKenzie, M Sherwood

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