Abstract | BACKGROUND: METHODS: Twenty-eight patients scheduled for thoracoscopic pectus excavatum surgery were randomly assigned to receive either thoracic epidural block or i.v. PCA for postoperative analgesia. Pain was assessed using a visual-analogue scale (VAS). The Ramsay sedation score, arterial pressure, ventilatory frequency, and heart rate were also measured, and blood gas analysis was performed regularly during the first 48 h after surgery. RESULTS: A significant decrease in the VAS pain score, Ramsay sedation score, heart rate ventilatory frequency, systolic and diastolic blood pressure, and PaCO2, and a significant increase in PaO2 and oxygen saturation were found over time. Patients in the PCA group had significantly higher PaCO2 values. In addition, a significantly slower decline of systolic blood pressure and heart rate, and faster recovery of PaCO2 were found in PCA patients than in patients with epidural block. CONCLUSIONS: I.V. fentanyl PCA is as effective as thoracic epidural for postoperative analgesia in children after thoracoscopic pectus excavatum repair. Bearing in mind the possible complications of epidural catheterization in children, the use of fentanyl PCA is recommended.
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Authors | D Butkovic, S Kralik, M Matolic, M Kralik, S Toljan, L Radesic |
Journal | British journal of anaesthesia
(Br J Anaesth)
Vol. 98
Issue 5
Pg. 677-81
(May 2007)
ISSN: 0007-0912 [Print] England |
PMID | 17363405
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Opioid
- Carbon Dioxide
- Oxygen
- Fentanyl
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Topics |
- Adolescent
- Analgesia, Epidural
(adverse effects, methods)
- Analgesia, Patient-Controlled
(adverse effects, methods)
- Analgesics, Opioid
(administration & dosage, adverse effects)
- Blood Pressure
(drug effects)
- Carbon Dioxide
(blood)
- Child
- Female
- Fentanyl
(administration & dosage, adverse effects)
- Funnel Chest
(surgery)
- Heart Rate
(drug effects)
- Humans
- Male
- Oxygen
(blood)
- Pain Measurement
(methods)
- Pain, Postoperative
(prevention & control)
- Partial Pressure
- Postoperative Care
(methods)
- Respiration
(drug effects)
- Thoracoscopy
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