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小儿群体术后硬膜外镇痛的安全性:一项回顾性分析。

Safety of post-operative epidural analgesia in the paediatric population: A retrospective analysis.

作者信息

Kasanavesi Ramakrishna Chaitanya, Gazula Suhasini, Pula Ravikanth, Thakur Nagarjuna

机构信息

Department of Paediatric Surgery, ESIC Super Speciality Hospital, Hyderabad, Telangana, India.

Department of Anaesthesia, ESIC Super Speciality Hospital, Hyderabad, Telangana, India.

出版信息

Indian J Anaesth. 2015 Oct;59(10):636-40. doi: 10.4103/0019-5049.167494.

Abstract

BACKGROUND AND AIMS

Epidural infusion analgesia (EIA) is among the common procedures performed in children to provide analgesia. However, the administration of epidural is not without complications. Limited studies are available regarding the safety of EIA in children with no studies from the Indian subcontinent. The aim of this study was to analyse all the complications that occured during administration and maintenance of EIA in paediatric patients.

METHODS

All children undergoing elective or emergency surgeries under general anaesthesia and given concomitant epidural analgesia for post-operative pain management were included. Data were collected by reviewing patient medical records, anaesthesia registers and post-operative intensive care unit charts. Statistical averages were drawn to assess the complication rates.

RESULTS

Seventy children received epidural analgesia during the span of study, of them five were neonates and fifteen were infants. No major complications that were life-threatening or leading to permanent disability were documented. Two children (2.85%) had blood tap during procedure. Eleven children (15%) had peri-catheter leaks and 14 children (20%) had catheter dislodgements.

CONCLUSION

EIA seems to be a relatively safe method of providing analgesia. It is associated with the occurrence of complications which are at best temporary.

摘要

背景与目的

硬膜外输注镇痛(EIA)是儿童常用的镇痛方法之一。然而,硬膜外给药并非没有并发症。关于儿童EIA安全性的研究有限,且没有来自印度次大陆的相关研究。本研究的目的是分析小儿患者在EIA给药和维持过程中发生的所有并发症。

方法

纳入所有在全身麻醉下接受择期或急诊手术并同时给予硬膜外镇痛以进行术后疼痛管理的儿童。通过查阅患者病历、麻醉记录和术后重症监护病房图表收集数据。计算统计平均值以评估并发症发生率。

结果

在研究期间,70名儿童接受了硬膜外镇痛,其中5名是新生儿,15名是婴儿。未记录到危及生命或导致永久性残疾的重大并发症。两名儿童(2.85%)在操作过程中出现穿破血管。11名儿童(15%)发生导管周围渗漏,14名儿童(20%)出现导管移位。

结论

EIA似乎是一种相对安全的镇痛方法。它与并发症的发生相关,这些并发症至多是暂时的。

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