J Korean Orthop Assoc.  2003 Jun;38(3):223-226.

Efficacy of Postoperative Patient Controlled Epidural Analgesia via the Lumbar Approach in Pediatric Patients Undergoing Lower Extremity Surgery

Affiliations
  • 1Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, Korea. hwpark@yumc.yonsei.ac.kr
  • 2Department of Anesthesiology and Pain Medicine, College of Medicine, Yonsei University, Seoul, Korea.

Abstract

PURPOSE
To evaluate the safety and efficacy of postoperative patient controlled epidural analgesia via the lumbar approach in children undergoing lower extremity surgery. MATERIALS AND METHODS: 40 patients between the ages of 5 and 12 years were randomly allocated into two groups; one group received conventional pain medications (intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n.) and the other group received patient controlled epidural analgesia. The composition of the analgesics in the experimental group was 0.1% bupivacaine +fentanyl 2 g/mL in 100 mL of normal saline. Pain scores were measured 3 times using a standardized pain scale containing questions regarding side effects - upon arrival at the ward, 6 hours thereafter and 24 hours after the first measurement. RESULTS: Pain scores were significantly lower in the epidural group with minimal side effects requiring no further treatment (p<0.01). A significant correlation was found between the number of boluses and the incidence of nausea/vomiting in epidural group (p<0.01). CONCLUSION: This study demonstrates the safety and efficacy of patient controlled epidural analgesia using low concentrations of bupi-vacaine and fentanyl, in pediatric patients undergoing lower extremity surgery.

Keyword

Pediatrics; Lower extremity surgery; Patient controlled epidural analgesia
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