[Hormonal response and two special techniques of postoperative analgesia in pediatric surgery].
OBJECTIVE
We studied neuroendocrine response in the postoperative pain relief in pediatric patients treated with two analgesic techniques (conventional intravenous analgesia and patient controlled analgesia).


METHODS
A double blind study was made in 30 patients, 6-14 year-old children, under total intravenous anesthesia for programmed surgery. An intravenous analgesia dose of 0.5 mg/Kg was given 10 minutes before operation was finished. Postoperative analgesia was achieved by two techniques: A. Patient controlled analgesia (PCA), and B. Conventional intravenous analgesia every 6 hours. Hormones measurements were made (catecholamines, cortisol, ACTH and beta-endorphin), hemodynamic monitoring (blood pressure and heart rate), and pain measurement (Hannallah's score) in both pre and postoperative times (1, 6 and 24 hours after operation).


RESULTS
Pain score was low and without significant differences in both groups (p > 0.05). beta-endorphin level decreased in both groups, and a cortisol and catecholamine level increase was noticed at 6 hours after operation; these changes were less significant in PCA group (p < 0.001). ACTH level did not change significantly in both groups. Hemodynamic monitoring measurements were not significantly different.


CONCLUSIONS
Both analgesic techniques were appropriate to postoperative pain relief in pediatric patients. Low pain score shows better conditions to attend these patients. We suggest PCA technique is better to treat postoperative stress response following pediatric surgery.
Palacio Rodríguez
M A
MA
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de las Nieves, Departamento de Fisiología, Universidad de Granada.
Castejón Casado
J
J
Palop Manjón-Cabeza
E
E
García Sánchez
M J
MJ
Sánchez López-Tello
C
C
Moreno Prieto
M
M
D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D016058:Analgesia, Patient-Controlled; D000700:Analgesics; D002395:Catecholamines / Q000097:blood; D002648:Child; D004311:Double-Blind Method; D006439:Hemodynamics; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D001615:beta-Endorphin / Q000097:blood
D000700:Analgesics; D002395:Catecholamines; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone