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Ketorolac or fentanyl continuous infusion for post-operative analgesia in children undergoing ureteroneocystostomy

Authors
 Y. Y. JO  ;  J. Y. HONG  ;  E. K. CHOI  ;  H. K. KIL 
Citation
 ACTA ANAESTHESIOLOGICA SCANDINAVICA, Vol.55(1) : 54-59, 2011 
Journal Title
 ACTA ANAESTHESIOLOGICA SCANDINAVICA 
ISSN
 0001-5172 
Issue Date
2011
MeSH
Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use* ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Child, Preschool ; Cystostomy* ; Double-Blind Method ; Female ; Fentanyl/administration & dosage ; Fentanyl/therapeutic use* ; Humans ; Infant ; Infusions, Intravenous ; Ketorolac/administration & dosage ; Ketorolac/therapeutic use* ; Kidney Function Tests ; Liver Function Tests ; Pain Measurement/drug effects ; Pain, Postoperative/drug therapy* ; Postoperative Nausea and Vomiting/epidemiology ; Spasm/prevention & control ; Treatment Outcome ; Ureter/surgery ; Urinary Bladder Diseases/prevention & control ; Vesico-Ureteral Reflux/etiology
Abstract
BACKGROUND: children undergoing ureteroneocystostomy suffer from post-operative pain due to the surgical incision and bladder spasm. A single-shot caudal block is a common technique for paediatric analgesia, but a disadvantage is the limitation of a short duration in spite of the additives co-administered. A few clinical trials have shown that ketorolac provides an effective post-operative analgesia and reduces the bladder spasms after ureteral implantation in children. We compared the efficacy of a continuous infusion of ketorolac and fentanyl in post-operative analgesia and bladder spasm in children who underwent ureteroneocystostomy. METHODS: fifty-two children were allocated to the ketorolac group (Group K, n=26) and fentanyl group (Group F, n=26). After general anaesthesia, a caudal block was performed with 1.5 ml/kg of 0.15% ropivacaine. At the beginning of surgery, an infusion was started after the bolus injection of ketorolac 0.5 mg/kg or fentanyl 1 microg/kg. An infusion device was programmed to deliver ketorolac 83.3 microg/kg/h or fentanyl 0.17 microg/kg/h for 48 h. RESULTS: two of Group F and three of Group K were excluded from the study. Post-operative pain scores were similar between the two groups. One of Group K (4%) and seven of Group F (30.4%) experienced bladder spasms. The rescue analgesic requirements were significantly less in Group K. CONCLUSIONS: a Continuous infusion of ketorolac provided effective analgesia after operation in children who underwent ureteroneocystostomy as well as a low dosage of fentanyl. Ketorolac was more effective in reducing the frequency of bladder spasms and rescue analgesic requirements.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2010.02354.x/abstract
DOI
10.1111/j.1399-6576.2010.02354.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Jo, Youn Yi(조윤이)
Hong, Jeong Yeon(홍정연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92694
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