Parent-controlled analgesia for postoperative management in children
10.3760/cma.j.issn.0254-1416.2009.11.007
- VernacularTitle:骨科下肢手术患儿术后父母控制静脉镇痛的效应
- Author:
Yiqi CHEN
;
Yu CHEN
;
Yunan SONG
- Publication Type:Journal Article
- Keywords:
Analgesia;
patient-controlled;
Children
- From:
Chinese Journal of Anesthesiology
2009;29(11):985-987
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of parent-controlled analgesia for postoperative pain management in pediatric patients. Methods Five hundred and seven ASA Ⅰ or Ⅱ pediatric patients aged 10 months to 8 yr, weighting 8.5-34.0 kg, undergoing lower limb operations performed under general anesthesia combined with caudal block were assigned into 2 age groups: group PCIA-P ( < 6 yr, n = 308) and group PCIA ( ≥6yr, n = 199). Anesthesia was induced with intravenous midazolam 1 mg/kg, ketamine 2 mg/kg and propofol 2 mg/kg. Laryngeal mask airway (LMA) was introduced or the patients were intubated. After induction, caudal block was performed with 0.25% bupivacaine 2.5 mg/kg with adrenaline 1:400 000. The patients received PCA with morphine after operation. The PCA pump was controlled by parent in group PCIA-P and by patient in group PCIA. The PCA regimen included a background infusion of morphine at a rate of 15μg~(-1)·kg~(-1)·h, a bolus of 15μg/kg and a 10 min lockout interval. The vital signs, pain score, sedation score, number of attempts, morphine dosage and side effects were recorded. Results The two groups were comparable with respect to the rate of satisfactory analgesia, level of sedation, number of attempts, morphine dosage and side effects. The rates of satisfactory analgesia were 72.7% and 80.2% in group PCIA-P vs 77.9% and 78.9% in group PCIA at 24 and 48 h after operation respectively ( P > 0.05) . Conclusion Parent-controlled analgesia could be used safely and effectively in children after orthopedic surgery.
