Articles: postoperative-pain.
-
Anesteziol Reanimatol · Jul 1999
Comparative Study[High thoracic epidural analgesia in the postoperative period after correction of congenital heart defects in children].
The effects and side effects of thoracic epidural analgesia on the respiratory response, awakening time, and cooperation with nurses were studied. Forty children received epidural analgesia after open-heart surgery. Lidocaine was injected in a dose of 1.5-2 mg/kg every 1.5-2 h. ⋯ Cooperation with nurses was much better in this group, too. No side effects were observed in the epidural group. Therefore, thoracic epidural analgesia is a safe and effective method of postoperative analgesia for children subjected to open-heart surgery.
-
The efficacy and safety of postoperative analgesia with continuous epidural infusion of either morphine or fentanyl in combination with a low dose of bupivacaine were evaluated in 205 patients after upper abdominal surgery. Each patient was given bupivacaine alone (0.125% or 0.25%) or one of six combinations; 0.25%, 0.125%, or 0.0625% bupivacaine with morphine (M: 10 micrograms.ml-1) or fentanyl (F: 1 microgram.ml-1). After injection of 6 ml of each solution at the end of surgery, continuous epidural infusion was started at a rate of 4.2 ml.hr-1 for 48 hr. ⋯ Regarding the plasma catecholamines measured 24 hr after the surgery, there was no significant change in fentanyl groups as well as in the group given 0.125% bupivacaine alone. Although the incidence of hypotension and pruritus was slightly higher in morphine groups, no patient developed respiratory depression. It is suggested, therefore, that a small dose of opioid should be added when continuous epidural infusion is required.