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Comparison of continuous epidural and intravenous analgesia for postoperative pain control in pediatric lower extremity surgery

 Sun Joon Bai  ;  Bon Nyeo Koo  ;  Yang Sik Shin  ;  Ki Hwan Kim  ;  Philip S. Doh  ;  Jong Hoon Kim 
 YONSEI MEDICAL JOURNAL, Vol.45(5) : 789-795, 2004 
Journal Title
Issue Date
Analgesia, Epidural* ; Anesthesia, General ; Child ; Child, Preschool ; Female ; Fentanyl/administration & dosage* ; Humans ; Lidocaine/administration & dosage* ; Lower Extremity/surgery* ; Male ; Pain, Postoperative/drug therapy* ; Postoperative Nausea and Vomiting/epidemiology
Children ; epidural analgesia ; intravenous analgesia ; lidocaine ; fentanyl
In recent years epidural anesthesia and analgesia techniques were used in pediatric surgery owing to the development of pediatric epidural catheter needles. And the need of postoperative pain control in pediatric patients is also increasing. We compared combined general-epidural anesthesia and analgesia technique with intravenous fentanyl analgesia after general anesthesia for postoperative analgesic effect and complications in these pediatric patients. We randomly allocated 91 pediatric patients undergoing lower extremities surgery into epidural lidocaine group (n=61) and IV fentanyl group (n=30). During the operation, end-tidal sevoflurane concentration (ETsev) was controlled to maintain the blood pressure and heart rate within 10% of preoperative value. At the postoperative period, Parent Visual Analog Scale (PVAS), Objective Pain Score (OPS) and the incidence of nausea/ vomiting were checked immediately, 6 hours and 24 hours after the patient's arrival at general ward. ETsev was significantly low in epidural lidocaine group (p < 0.05). Compare to IV fentanyl group, epidural lidocaine group had significantly lower OPSs at 6 hours after arrival. Epidural lidocaine group had significantly lower PVASs immediately, 6 hrs and 24 hours after arrival. There was no significant difference in the incidence of postoperative nausea and vomiting. A combined general-epidural anesthesia technique significantly reduces intraoperative end-tidal sevoflurane concentration compared to general anesthesia alone. And continuous patient-controlled epidural analgesia reduces postoperative pain scores significantly more than continuous patient-controlled IV fentanyl analgesia without any serious complications in pediatric lower extremity surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, Jong Hoon(김종훈)
Bai, Sun Joon(배선준) ORCID logo https://orcid.org/0000-0001-5027-3232
Shin, Yang Sik(신양식)
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