Comparison of Epidural Opioids and Intravenous Opioids in the Postoperative Management of Pediatric Anti-reflux Surgery

Epidural and subarachnoid blockade in children

“…The catabolic stress response to surgery is modified by epidural anaesthesia and analgesia [50–52] and in certain circumstances there is evidence that the postoperative outcome in high‐risk cases is favourably influenced by epidural analgesia. Groups in which this appears to be the case include patients with gastro‐oesophageal reflux undergoing fundoplication [53], children with respiratory disabilities undergoing abdominal surgery [54] and neonates undergoing repair of oesophageal atresia [55]. However, despite the enthusiasm for epidural analgesia in children and its perceived advantages there is limited objective evidence that postoperative epidural analgesia after major surgery in children is more effective than intravenous opioid analgesia.…”