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Epidural Bolus Versus Continuous Epidural Infusion Analgesia on Optic Nerve Sheath Diameter in Paediatric Patients: A Prospective, Double-Blind, Randomised Trial

 Bora Lee  ;  Jae Hoon Lee  ;  Min-Soo Kim  ;  Seon Ju Kim  ;  Jeehyun Song  ;  Do-Hyeong Kim  ;  Yong Seon Choi 
 SCIENTIFIC REPORTS, Vol.10(1) : e5477, 2020-03 
Journal Title
Issue Date
The use of programmed intermittent epidural bolus for postoperative analgesia may have greater analgesic efficacy than continuous epidural infusion. However, the rapid delivery speed used with an epidural bolus is more likely to increase intracranial pressure. We compared the effects of lumbar epidural bolus versus continuous infusion epidural analgesia on intracranial pressure in children using optic nerve sheath diameter as a marker. We randomly assigned 40 paediatric patients to bolus or infusion groups. Epidural analgesia (0.15% ropivacaine 0.3 ml·kg-1) was administered via bolus or infusion. Ultrasonography was used to measure the optic nerve sheath diameter before (T0), at 3 min (T1), 10 min (T2), and 70 min (T3) after starting the pump. There were statistically significant between-group differences in optic nerve sheath diameter over time (PGroup x Time = 0.045). From T0-T3, the area under the curve values were similar between the two groups. Although there were differences in the patterns of optic nerve sheath diameter change according to the delivery mode, the use of lumbar epidural bolus did not increase the risk of intracranial pressure increase over that of continuous infusion. Further research is needed to investigate intracranial pressure changes after continuous application of each delivery mode.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Lee, Bo Ra(이보라) ORCID logo https://orcid.org/0000-0002-7699-967X
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
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