title: Continuous epidural morphine/butorphanol infusion following selective dorsal rhizotomy in children.
abstract: The authors prospectively evaluated 15 patients who had undergone selective dorsal rhizotomy who were given a continuous morphine/butorphanol infusion, to determine whether variations in the postoperative pain control and side effects seen using a bolus technique could be reduced. Patients had an epidural catheter placed at the end of the operative procedure through which 50-60 micrograms/kg preservative-free morphine and 15-20 micrograms/kg butorphanol was administered. A continuous epidural infusion of 5 micrograms/kg h morphine and 1.2 micrograms/kg h butorphanol was then initiated. Postoperatively, mean pain scores were excellent. No patient required additional systemic analgesics during the 72-h investigational period. A low incidence of nausea, and no vomiting, pruritus, or respiratory depression was reported by the cohort. All patients maintained oxygen saturations above 95%. This indicates that the use of a continuous epidural infusion provides excellent pain control, decreases the occurrence of untoward side effects, and allows the early initiation of occupational and physical therapy postoperatively.
authors.affiliation: Department of Anesthesiology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock 72202-3591, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Lawhorn
authors.forename: F A
authors.initials: FA
authors.lastname: Boop
authors.forename: R E
authors.initials: RE
authors.lastname: Brown
authors.forename: P D
authors.initials: PD
authors.lastname: Andelman
authors.forename: M L
authors.initials: ML
authors.lastname: Schmitz
authors.forename: P J
authors.initials: PJ
authors.lastname: Kymer
authors.forename: R
authors.initials: R
authors.lastname: Shirey
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D017217:Blood Patch, Epidural; D001794:Blood Pressure; D002077:Butorphanol / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D006339:Heart Rate; D006801:Humans; D007263:Infusions, Parenteral; D007268:Injections, Epidural; D009020:Morphine / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D012119:Respiration; D019051:Rhizotomy; D013126:Spinal Nerve Roots / Q000601:surgery
chemical_list: D000700:Analgesics; D009020:Morphine; D002077:Butorphanol