title: Parent-controlled analgesia in children undergoing cleft palate repair.
abstract: The aims of this study were to find an optimal basal infusion dose of fentanyl for parent-controlled analgesia (PrCA) in children undergoing cleft palate repair and the degree of parents' satisfaction with PrCA. Thirty consecutive children between 6 months and 2 yr of age were enrolled. At the end of surgery, a PrCA device with a basal infusion rate of 2 mL/hr and bolus of 0.5 mL with lockout time of 15 min was applied. Parents were educated in patient-controlled analgesia (PCA) devices, the Wong Baker face pain scoring system, and monitoring of adverse effects of fentanyl. Fentanyl was infused 0.3 microgram/kg/hr at first, and we obtained a predetermined fentanyl regimen by the response of the previous patient to a larger or smaller dose of fentanyl (0.1 microgram/kg/hr as the step size), using an up-and-down method. ED50 and ED95 by probit analysis were 0.63 microgram/kg/hr (95% confidence limits, 0.55-0.73 microgram/kg/hr) and 0.83 microgram/kg/hr (95% confidence limits, 0.73-1.47 microgram/kg/hr), respectively. Eighty seven percent of the parents were satisfied with participating in the PrCA modality. PrCA using fentanyl with a basal infusion rate of 0.63 microgram/kg/hr can be applied effectively for postoperative pain management in children undergoing cleft palate repair with a high level of parents' satisfaction.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Lee
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Sun Jun
authors.initials: SJ
authors.lastname: Bai
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Beyoung Yun
authors.initials: BY
authors.lastname: Park
authors.forename: Kyeong Tae
authors.initials: KT
authors.lastname: Min
mesh_terms: D016058:Analgesia, Patient-Controlled; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents
chemical_list: D005283:Fentanyl