BACKGROUND: We examined the effects of lumbar epidural morphine for postoperative analgesia in children after the Nuss procedure for funnel chest. METHODS: An epidural catheter was inserted from the L 3-4 interspace preoperatively (epidural group). Epidural morphine 30 microg x kg(-1) was given at the beginning of the operation. Postoperatively, epidural morphine 3 microg x kg(-1) x hr(-1) was infused. The frequency of demand for postoperative analgesia was retrospectively compared with that of children who had not received epidural morphine (control group). RESULTS: On the 0th postoperative day, the epidural group required fewer analgesics than the control group (0.50+/-0.30 vs. 2.50+/-1.00 x day(-1)). However, after the 1st postoperative day, the demand for analgesia did not differ between the two groups. CONCLUSIONS: Epidural morphine 30 microg x kg(-1) given at the beginning of operation provided effective analgesia on the 0th postoperative day after the Nuss procedure. However, epidural infusion of morphine 3 microg x kg(-1) x hr(-1) was not effective after the 1st postoperative day. Further study is needed to determine the lumbar epidural infusion dose of morphine adequate for use after the Nuss procedure.
BACKGROUND: We examined the effects of lumbar epidural morphine for postoperative analgesia in children after the Nuss procedure for funnel chest. METHODS: An epidural catheter was inserted from the L 3-4 interspace preoperatively (epidural group). Epidural morphine 30 microg x kg(-1) was given at the beginning of the operation. Postoperatively, epidural morphine 3 microg x kg(-1) x hr(-1) was infused. The frequency of demand for postoperative analgesia was retrospectively compared with that of children who had not received epidural morphine (control group). RESULTS: On the 0th postoperative day, the epidural group required fewer analgesics than the control group (0.50+/-0.30 vs. 2.50+/-1.00 x day(-1)). However, after the 1st postoperative day, the demand for analgesia did not differ between the two groups. CONCLUSIONS: Epidural morphine 30 microg x kg(-1) given at the beginning of operation provided effective analgesia on the 0th postoperative day after the Nuss procedure. However, epidural infusion of morphine 3 microg x kg(-1) x hr(-1) was not effective after the 1st postoperative day. Further study is needed to determine the lumbar epidural infusion dose of morphine adequate for use after the Nuss procedure.
Authors: Andrea M Stroud; Darena D Tulanont; Thomasena E Coates; Philip P Goodney; Daniel P Croitoru Journal: J Pediatr Surg Date: 2014-02-22 Impact factor: 2.545