Ohta K, Katsuno M, Kawana S, Namiki A
Division of Anesthesia, Hokkaido Prefectural Rehabilitation Center for Physically Handicapped Children, Sapporo.
Masui. 1993 May;42(5):664-8.
The safety and efficacy of epidural opioids as postoperative analgesics for children with cerebral palsy were studied in 85 pediatric patients with cerebral palsy. The patients were 5 to 15 years of age and were undergoing elective orthopedic operations on the lower extremities. These patients were divided into four groups. All the patients received inhalational anesthesia combined with caudal anesthesia, while the patients in groups 2, 3, and 4 were given epidural morphine (40 micrograms.kg-1), buprenorphine (3 micrograms.kg-1), or butorphanol (30 micrograms.kg-1) at the end of operation, respectively. Number of patients who received analgesics more than 2 times within 24 hours after operation was larger in group 1 than in groups 2-4. Although groups 2-4 compared with group 1 were still sedated at 24 hours after the operation, there was no difference in degree of sedation among the groups 2-4. The epidural opioids did not increase the frequency of side effects such as nausea, vomiting etc. The authors conclude that epidural opioids achieve safe and useful postoperative pain control in children with cerebral palsy.
在85例小儿脑瘫患者中研究了硬膜外使用阿片类药物作为脑瘫患儿术后镇痛药的安全性和有效性。患者年龄为5至15岁，正在接受下肢择期骨科手术。这些患者被分为四组。所有患者均接受吸入麻醉联合骶管麻醉，而第2、3和4组患者在手术结束时分别给予硬膜外吗啡（40微克·千克⁻¹）、丁丙诺啡（3微克·千克⁻¹）或布托啡诺（30微克·千克⁻¹）。术后24小时内接受镇痛药超过2次的患者数量，第1组多于第2 - 4组。虽然与第1组相比，第2 - 4组在术后24小时仍有镇静作用，但第2 - 4组之间的镇静程度没有差异。硬膜外阿片类药物并未增加恶心、呕吐等副作用的发生率。作者得出结论，硬膜外阿片类药物可实现脑瘫患儿术后安全有效的疼痛控制。
