Comparison of regional vs systemic analgesia for post‐thoracotomy care in infants

Abstract

In infants undergoing thoracotomy, loco-regional analgesia is effective and associated with a reduced intensity of postoperative care and earlier full feeding than systemic analgesia; it should therefore be considered a better option.

Comparison of caudal ropivacaine‐morphine and paravertebral catheter for major upper abdominal surgery in infants

“…Our data showed that BOPS pain scores were only statistically lower at 24 h after surgery in Group P when compared to Group C. It has been shown that morphine provides long-lasting analgesia as an adjuvant in caudal block approaches (17), but that side effects, such nausea, urinary retention, pruritus, and respiratory depression, are common (18). A previous study suggested that infants receiving catheter analgesia can be fed sooner and that they have improved intestinal motility when compared to infants receiving systemic analgesia (19). Our results were partially consistent with these reports, and therefore advocate that a single shot of morphine (our median dose = 0.03 mgÁkg À1 ) (20) via caudal block can provide analgesia that lasts less than 24 h and that the abovementioned dose does not significantly contribute to negative effects in infants.…”

A retrospective comparison of ropivacaine and 2‐chloroprocaine continuous thoracic epidural analgesia for management of postthoracotomy pain in infants

“…Multiple studies have validated the use of continuous epidural infusions in neonates and infants and shown regional anesthesia to be an effective strategy in a variety of surgical procedures including thoracotomy . For our comparative study, we selected a population of patients that was relatively homogeneous in terms of age, comorbidities, surgical indication, and intervention.…”

“…Continuous thoracic epidural analgesia (CTEA) has been shown to be an effective strategy in the management of pain in neonates and infants following thoracotomy for lung resection . The benefits of CTEA in this population include improved cardiorespiratory status when compared to systemic opioid‐based management . The choice of local anesthetic (LA) is complicated by concerns about drug accumulation with continuous infusions of amide local anesthetics in children less than a year .…”

Eficacia analgésica y complicaciones a corto plazo de catéteres peridurales lumbares y torácicos en pacientes pediátricos: una evaluación retrospectiva

“…El manejo del dolor agudo en pacientes pediátricos, especialmente en recién nacidos, ha tenido importantes cambios en los últimos 20 años y es trascendental considerar que un manejo inadecuado del dolor en estos pacientes puede tener consecuencias adversas a corto y largo plazo (Peters et al, 2005;Gómez-Chacón et al, 2012;Di Pede et al, 2014). Aunque existen nuevas técnicas de anestesia regional periférica para cirugías abdominales y torácicas, la analgesia peridural lumbar y torácica sigue siendo una técnica analgésica exitosa y segura.…”