title: An audit of extradural infusion analgesia in children using bupivacaine and diamorphine.
abstract: One hundred and fifty extradural infusions of diamorphine and bupivacaine after major surgery in children were audited over a 15 month period. The majority of the children (69%) were less than 5 years of age. Analgesia was assessed or self-rated as 'very good' in over 75% of patients. Urinary retention was seen in 11% of patients and pruritus in 10%. Respiratory depression requiring intervention was only seen in one patient--a premature infant of 39 weeks post-conceptual age. Technical complications resulted in the early loss of 16.7% of the infusions. Although analgesia was good the complexity of the extradural infusion technique demanded significant medical and nursing time especially to overcome technical problems.
authors.affiliation: Acute Pain Service, Hospitals for Sick Children, London.
authors.forename: P T
authors.initials: PT
authors.lastname: Wilson
authors.forename: A R
authors.initials: AR
authors.lastname: Lloyd-Thomas
mesh_terms: D000293:Adolescent; D015360:Analgesia, Epidural / Q000592:standards*; D002045:Bupivacaine / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008131:London; D008485:Medical Audit; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011537:Pruritus / Q000139:chemically induced; D012131:Respiratory Insufficiency / Q000139:chemically induced; D016896:Treatment Outcome; D016055:Urinary Retention / Q000139:chemically induced
chemical_list: D003932:Heroin; D002045:Bupivacaine