[Epidural opioids for post-operative pain control in pediatric patients with cerebral palsy].
The safety and efficacy of epidural opioids as postoperative analgesics for children with cerebral palsy were studied in 85 pediatric patients with cerebral palsy. The patients were 5 to 15 years of age and were undergoing elective orthopedic operations on the lower extremities. These patients were divided into four groups. All the patients received inhalational anesthesia combined with caudal anesthesia, while the patients in groups 2, 3, and 4 were given epidural morphine (40 micrograms.kg-1), buprenorphine (3 micrograms.kg-1), or butorphanol (30 micrograms.kg-1) at the end of operation, respectively. Number of patients who received analgesics more than 2 times within 24 hours after operation was larger in group 1 than in groups 2-4. Although groups 2-4 compared with group 1 were still sedated at 24 hours after the operation, there was no difference in degree of sedation among the groups 2-4. The epidural opioids did not increase the frequency of side effects such as nausea, vomiting etc. The authors conclude that epidural opioids achieve safe and useful postoperative pain control in children with cerebral palsy.
Division of Anesthesia, Hokkaido Prefectural Rehabilitation Center for Physically Handicapped Children, Sapporo.
K
K
Ohta
M
M
Katsuno
S
S
Kawana
A
A
Namiki
D000293:Adolescent; D015360:Analgesia, Epidural; D002047:Buprenorphine; D002077:Butorphanol; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D009020:Morphine; D009985:Orthopedics; D010149:Postoperative Pain / Q000517:prevention & control*
D002047:Buprenorphine; D009020:Morphine; D002077:Butorphanol