Systemic postoperative pain management following minimally invasive pectus excavatum repair in children and adolescents: a retrospective comparison of intravenous patient-controlled analgesia and continuous infusion with morphine.

Abstract

PURPOSE:

Optimal postoperative pain management following minimally invasive surgical repair of pectus excavatum is not established. We compared efficacy and adverse effects in patients treated with patient-controlled analgesia (PCA) with those treated with continuous infusion (CI) with morphine in addition to nonsteroidal anti-inflammatory drugs.

METHODS:

33 patient records were examined retrospectively: 21 given PCA and 12 CI with morphine. Main outcome variables were used doses of morphine, pain scores every 3 h and adverse effects.

RESULTS:

Median (range) used morphine dose was 0.58 (0.21-1.12) and 0.52 (0.34-0.84) mg/kg on the day 1 and 0.3 (0.02-0.6) and 0.33 (0.09-0.53) mg/kg on the day 2 in PCA and CI groups, respectively (p > 0.05). Pain scores were within moderate and low levels during 42 h after surgery and did not differ between the groups. Median (range) oxygen saturation was 96.5 (93-100) and 97 (94-100) in PCA and CI groups, respectively (p > 0.05). Additional oxygen therapy was required in 14.3% in PCA group and 25% in CI group (p > 0.05). The incidence of pulmonary adverse effects was rare and did not differ between the groups.

CONCLUSION:

Both methods of systemic analgesia in addition to non-opioid analgesics were equally effective and resulted in a low incidence of pulmonary adverse effects.

• Authors: Danguole Ceslava Rugyte, Arturas Kilda, Aurika Karbonskiene, Vidmantas Barauskas
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 26 Issue 7 Pg. 665-9 (Jul 2010) ISSN: 1437-9813 [Electronic] Germany
• PMID: 20490811 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Analgesics, Opioid
• Anti-Inflammatory Agents, Non-Steroidal
• Morphine

Topics

• Adolescent
• Analgesia, Patient-Controlled (methods)
• Analgesics, Opioid (administration & dosage)
• Anesthesia, Intravenous
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Child
• Female
• Funnel Chest (surgery)
• Humans
• Infusions, Intravenous
• Male
• Morphine (administration & dosage)
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Retrospective Studies
• Young Adult