Arms D M, Smith J T, Osteyee J, Gartrell A
Department of Orthopedic Surgery, Primary Children's Medical Center, Salt Lake City, Utah 84113, USA.
Orthopedics. 1998 May;21(5):539-44.
The safety of epidural infusion for postoperative analgesia in pediatric spine surgery continues to be established. A continuous epidural infusion of morphine sulfate and bupivacaine was used for postoperative analgesia in 12 pediatric patients undergoing spinal surgery. The epidural was placed intraoperatively by the operating surgeon, while continuous infusion was managed postoperatively by a pediatric anesthesiology pain service team. In addition to the continuous infusion, 2 of the 12 also were provided on-demand patient-controlled boluses via epidural catheter for breakthrough pain. Patients experienced analgesia as documented by a comprehensive pain scale form. No catheters failed, while side effects were minimal and easily managed. These results provide confirmation of the safety and efficacy of continuous epidural infusion for postoperative analgesia following pediatric spine surgery and evidence that patient-controlled epidural analgesia is an option.
小儿脊柱手术术后硬膜外输注镇痛的安全性仍在确立中。对12例接受脊柱手术的小儿患者采用持续硬膜外输注硫酸吗啡和布比卡因进行术后镇痛。硬膜外导管由手术医生在术中放置，而持续输注在术后由小儿麻醉疼痛服务团队管理。除持续输注外，12例患者中有2例还通过硬膜外导管按需进行患者自控推注以缓解爆发痛。通过综合疼痛量表记录显示患者获得了镇痛效果。没有导管出现故障，副作用轻微且易于处理。这些结果证实了小儿脊柱手术后持续硬膜外输注镇痛的安全性和有效性，并有证据表明患者自控硬膜外镇痛是一种选择。
