Continuous epidural morphine/butorphanol infusion following selective dorsal rhizotomy in children.
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.
Lawhorn
C D
CD
Department of Anesthesiology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock 72202-3591, USA.
Boop
F A
FA
Brown
R E
RE
Andelman
P D
PD
Schmitz
M L
ML
Kymer
P J
PJ
Shirey
R
R
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
D000700:Analgesics; D009020:Morphine; D002077:Butorphanol