The analgesic efficacy and neuroendocrine response in paediatric patients treated with two analgesic techniques: using morphine-epidural and patient-controlled analgesia

Paediatric Anaesthesia
Pervin Bozkurt

Abstract

Pain treatment is one of the main concerns of paediatric anaesthesiologists. The purpose of this study was to assess and compare the quality of analgesia and stress suppression by morphine when used [epidural (single shot) (EP) or with intravenous (i.v.) for patient-controlled analgesia (PCA) in children]. Forty-four children, aged 5-15 years, and who were undergoing major genitourinary or lower abdominal surgery with a standardized general anaesthesia technique, were included in this study. In the EP group (n=24) 0.1 mg x kg(-1) morphine in 0.2 ml x kg(-1) saline were given epidurally at the L3-4 level and in the PCA group (n=20) 0.1 mg x kg-1 morphine was given i.v. immediately after intubation. Postoperative PCA bolus doses were 0.5 mg for patients weighing less than 20 kg, 1 mg for children weighing 20-30 kg and 1.5 mg for children weighing 30-40 kg. Blood samples were withdrawn following induction and at 1, 8, 12 and 24 h after morphine administration for measurement of blood glucose, insulin, cortisol and morphine levels. Patients were observed for 24 h postoperatively; heart rate, systolic blood pressure, respiratory rate, FACES pain scores, sedation scores and complications were recorded. The PCA group received 0.56 +/-...Continue Reading

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Citations

May 24, 2005·Journal of Pain and Symptom Management·Klaus A Lehmann
Feb 2, 2010·American Journal of Surgery·Wendy F BowerC Andrew van Hasselt
Jul 9, 2003·Paediatric Anaesthesia·Pervin BozkurtGulsev Kavunoglu
Apr 24, 2004·Journal of Pediatric Orthopedics·José A HerreraSusan L Foad
Oct 5, 2006·Current Opinion in Anaesthesiology·Lucinda L Everett
Oct 6, 2006·Current Opinion in Anaesthesiology·Robert Sümpelmann, Sinikka Münte
Oct 6, 2006·Current Opinion in Anaesthesiology·Jane M Peutrell, Per-Arne Lonnqvist
Apr 9, 2021·Pediatric Surgery International·Sara A MansfieldKyle J Morgan

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