Regional anesthesia in pediatric surgery: Complications and postoperative comfort level in 174 children

Pietropaoli, John A.; Keller, Martin S.; Smail, David F.; Abajian, John; Kreutz, Joseph M.; Vane, Dennis W.

doi:10.1016/0022-3468(93)90616-s

Cited by 37 publications

(27 citation statements)

References 20 publications

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“…The two frightening but uncommon complications of paediatric epidural analgesia are convulsions in-the present study were low also when compared with reports of epidural analgesia in children [10,17,18]. duced by local anaesthetics and serious respiratory depression due to the effect of opioids.…”

Section: Methodscontrasting

confidence: 38%

“…In 8% of the cases the epidural treatment failed or was terminated early due Pietropaoli et al [17], while Caudle et al [18] administered fentanyl at a base rate of 0.56±0.18 g kg −1 to catheter problems. In 8% of the cases the epidural treatment failed or was terminated early due Pietropaoli et al [17], while Caudle et al [18] administered fentanyl at a base rate of 0.56±0.18 g kg −1 to catheter problems.…”

Section: Methodsmentioning

confidence: 99%

“…scored for any sign of nausea while others [10,17,21] define nausea as a problem only if it needs medical intervention. More active unpleasant and frequent side effect of the epidural measures have to be undertaken to prevent and/or treatment in this study.…”

Section: Methodsmentioning

confidence: 99%

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Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Løvstad¹,

Halvorsen²,

Ræder³

et al. 1997

Eur J Anaesthesiol

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The efficacy and side effects of 100 lumbar epidural treatments with low concentrations of bupivacaine (1 mg mL-1), fentanyl (2 micrograms mL-1) and adrenaline (2 micrograms mL-1) combined with rectal paracetamol were prospectively evaluated in children aged 4-14 years after femoral osteotomy. The mean treatment time was 43 h and the mean dose was 0.18 mL kg-1 h-1. Ninety-nine per cent of the children were either without pain or experienced very low pain at rest for at least 80% of the treatment time. The same was the case in 80% of children when pain evaluation was made on active movement. No cases of seizures, signs of catheter migration, hypotension or respiratory depression were observed. Sixty-three per cent of the patients experienced nausea or vomiting, but antiemetic treatment was indicated in only 11%. One epidural treatment had to be stopped in a child who did not respond to antiemetics. The incidence of pruritus was high (49%), but the symptoms were mild and limited.

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Section: Methodscontrasting

confidence: 38%

Section: Methodsmentioning

confidence: 99%

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Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Løvstad¹,

Halvorsen²,

Ræder³

et al. 1997

Eur J Anaesthesiol

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show abstract

“…pivacaine and adrenaline combined with rectal paracetamol appears to be an effective analgesic regimen Nausea alone or nausea and vomiting occurred in Parents were asked to stay with the children Nausea alone and nausea and vomiting 63 (score 1, 2 and 3) Nausea and more than two episodes of 12 11 children received vomiting (score 3) antiemetics without any serious complications in children after a epidural infusion of fentanyl (in combination with bupivacaine) was 0.9 g kg −1 h −1 in a study by major orthopaedic surgery. In 8% of the cases the epidural treatment failed or was terminated early due Pietropaoli et al [17], while Caudle et al [18] administered fentanyl at a base rate of 0.56±0.18 g kg −1 to catheter problems.…”

Section: Discussionmentioning

confidence: 99%

Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Løvstad

Halvorsen

Ræder

et al. 1997

European Journal of Anaesthesiology

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Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effectsSummary children when pain evaluation was made on active movement. No cases of seizures, signs of catheter The efficacy and side effects of 100 lumbar epidural migration, hypotension or respiratory depression treatments with low concentrations of bupivacaine were observed. Sixty-three per cent of the patients (1 mg mL −1 ), fentanyl (2 g mL −1 ) and adrenaline (2 g experienced nausea or vomiting, but antiemetic treat-mL −1 ) combined with rectal paracetamol were proment was indicated in only 11%. One epidural treatspectively evaluated in children aged 4-14 years after ment had to be stopped in a child who did not respond femoral osteotomy. The mean treatment time was 43 h to antiemetics. The incidence of pruritus was high and the mean dose was 0.18 mL kg −1 h −1 . Ninety-nine (49%), but the symptoms were mild and limited. per cent of the children were either without pain or experienced very low pain at rest for at least 80% of

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“…Extradural infusion analgesia (EIA) is an accepted method of pain relief for children after major surgery ( 1–3). The contents of the infusion vary, but common practice is to add 1 mg of diamorphine to 50 ml of 0.125% bupivacaine ( 1).…”

Section: Introductionmentioning

confidence: 99%

Postoperative extradural infusions in children: preliminary data from a comparison of bupivacaine/diamorphine with plain ropivacaine

Moriarty

1999

Pediatric Anesthesia

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To try to decrease the incidence of side-effects associated with postoperative extradural infusions of local anaesthetics in combination with opioids, we have used plain ropivacaine solutions in 200 children. The first 72 children received an infusion of bupivacaine 0.125% + diamorphine 20 microg x ml-1, then 200 children received plain ropivacaine solutions. The children who received ropivacaine were found to have lower incidences of nausea, pruritus, urinary retention, and were less sedated, despite comparable analgesia. The management of plain ropivacaine for extradural analgesia is discussed.

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Regional anesthesia in pediatric surgery: Complications and postoperative comfort level in 174 children

Cited by 37 publications

References 20 publications

Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Post-operative epidural analgesia with low dose fentanyl, adrenaline and bupivacaine in children after major orthopaedic surgery. A prospective evaluation of efficacy and side effects

Postoperative extradural infusions in children: preliminary data from a comparison of bupivacaine/diamorphine with plain ropivacaine

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