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Effects of Postoperative Patient Controlled Epidural Analgesia in Pediatric Patients Undergoing Lower Extremity Surgery

 Jae Kwang Shim  ;  Jeong Il Kim  ;  Yong Taek Nam  ;  Kyeong Tae Min  ;  Sung In Choi 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.44(6) : 14-19, 2003 
Journal Title
 Journal of Korean Society of Anesthesiologist (대한마취과학회지) 
Issue Date
lower extremities surgery ; patient controlled epidural analgesia ; pediatric
lower extremities surgery ; patient controlled epidural analgesia ; pediatric
Background: A limited number of studies have been conducted on postoperative epidural analgesia in pediatric patients. There have been primarily dealt with spinal or abdominal surgeries where multiple dermatomal segments needed to be blocked and morphine was given either through the caudal approach or by direct catheter placement. This study evaluated the safety and efficacy of postoperative continuous patient controlled epidural analgesia (PCEA) in children undergoing lower extremity surgery using a bupivacaine and fentanyl via lumbar approach. Methods: The patient population consisted of 40 children ranging in age from 5 to 12 years. Patients were randomly divided into two groups according to postoperative pain relief regimen; the control group received an intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n., and the epidural group received PCEA (0.1% bupivacaine + fentanyl 2μg/ml) through an epidural catheter positioned at the surgical dermatomal level of the spinal cord. In the epidural group the volume of the initial dose was 1 ml/segment in children ≤ 10 years of age and dose (age in years) ml/10/segment in children > 10 years of age. The basal infusion rate was 0.1 ml/kg/hr (bolus: 0.05 ml/kg, lockout time: 30 minutes). Pain scores were measured upon arrival at the ward, and 6 and 24 hours thereafter. Results: The epidural group had significantly lower pain scores and minimal side effects. A significant correlation was observed between the bolus number and the incidence of nausea/vomiting in the epidural group. Conclusions: This study shows that PCEA targeted at the surgical dermatome is a safer and more effective regimen for postoperative pain relief than conventional postoperative pain relief in pediatric patients undergoing lower extremity surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
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