PMID: 9646655Jul 1, 1998Paper

Thoracic epidural analgesia in the postoperative period of pediatric surgery for the repair of pectus excavatum and pectus carinatum

Revista española de anestesiología y reanimación
L Cánovas MartínezA Castro Méndez

Abstract

To assess thoracic analgesia by continuous infusion in surgery to repair pectus excavatum and carinatum in children. This prospective study enrolled 14 children aged 6 to 14 years old scheduled for surgery to correct pectus excavatum and carinatum. After induction of general anesthesia, the T8-T9 epidural space was accessed and a catheter was inserted to T3-T7 with radioscopic monitoring. A loading dose of 0.03-0.04 ml/kg per segment to be blocked (5 segments: T3-T8) of 0.125% bupivacaine and 3 micrograms/ml fentanyl was given to children under 7 years of age; a dose of 0.02-0.03 ml/kg per segment was administered to children over the age of 7 years. A continuous perfusion of 0.1-0.4 ml/kg/h was maintained, with the possibility of additional boluses of 1 ml at 20 min intervals during surgery and the first three days thereafter. An intraoperative bolus was given when the level of blockade was not reached or when mean blood pressure and heart rate increased 15% over baseline. Pain relief was assessed on a numerical scale of 0 to 5 or on a scale of facial icons, depending on the patient's age. During the postoperative period, the pediatric ICU nurse administered a bolus if pain was [symbol see text]3 or heart rate increased 75% ov...Continue Reading

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