title: The effect of continuous wound infusion of ropivacaine on postoperative pain after median sternotomy and mediastinal drain in children.
abstract: Postoperative pain after median sternotomy is usually treated with i.v. opioids. We hypothesized that continuous wound infusion of ropivacaine decreases postoperative morphine consumption and improves analgesia in children who undergo cardiac surgery.
  
  
  
  This randomized, double-blind study comprised 49 children aged 1-9 years who underwent atrial septal defect (ASD) closure. Patients received continuous local anesthetic wound infiltration either with 0.2% ropivacaine, 0.3-0.4 mg·kg(-1) ·h(-1) (Group R) or with saline (Group C). Rescue morphine consumption, Objective Pain Scale (OPS), time to mobilization, time to enteral food intake, and time to discharge were recorded.
  
  
  
  There were no statistically significant differences in morphine consumption at 24, 48, and 72 h postsurgery between R and C groups. There was a weak evidence for a difference in the time to the first morphine administration after tracheal extubation to be longer for Group R than Group C (186.2 vs 81.0 min; 95% CI (-236.5, 26.2), P = 0.114). The incidence of nausea and vomiting were comparable between the groups. No signs or symptoms of local anesthetic toxicity were registered.
  
  
  
  Contrary to our hypothesis, continuous ropivacaine wound infusion did not reduce morphine consumption, pain score values, or nausea and vomiting in children who underwent ASD closure with median sternotomy and mediastinal drain.
authors.affiliation: Division of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Mattila
authors.affiliation: Division of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Tommi
authors.initials: T
authors.lastname: Pätilä
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Rautiainen
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Reijo
authors.initials: R
authors.lastname: Korpela
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Nikander
authors.affiliation: Division of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Puntila
authors.affiliation: Division of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Salminen
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Pertti K
authors.initials: PK
authors.lastname: Suominen
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Tynkkynen
authors.affiliation: Division of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Hiller
mesh_terms: D000577:Amides / Q000008:administration & dosage* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral / Q000379:methods; D008297:Male; D008482:Mediastinum / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077212:Ropivacaine; D056346:Sternotomy; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
keywords: analgesia; anesthetic techniques; continuous ropivacaine infusion; pediatrics; postoperative; regional; surgery