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Perioperative epidural analgesia in children undergoing major abdominal tumor surgery--a single center experience.

AbstractPURPOSE:
The purpose of this study was to assess the use of continuous epidural analgesia in pediatric patients undergoing major abdominal tumor surgery.
METHODS:
Children undergoing major abdominal tumor surgery at our institution between 2008 and 2012 (n=40) received continuous epidural analgesia via an epidural catheter. Surgical trauma scores, pain scores, and clinical data of the children were compared to a pair-matched historical control group operated on between 2002 and 2007 without epidural analgesia.
RESULTS:
Pain levels in the study group on day 1 and 3 after surgery were lower compared to the control group. The differences did, however, not reach statistical significance (p=0.15 and 0.09). Children in the study group received significantly fewer additional doses of piritramide or morphine (45% versus 82%, p<0.001). Despite significantly higher surgical trauma scores in the study group (p=0.018), there were no statistical differences regarding clinical parameters, such as mechanical ventilation time, time on intensive care unit, and total hospital stay. There were no catheter-related complications.
CONCLUSIONS:
Continuous epidural analgesia is beneficial for children undergoing complex abdominal tumor surgery with regard to pain levels, postoperative recovery, and general clinical course. Expertise of the managing team, a careful patient selection, and a continuous quality assessment are essential for success.
AuthorsSteven W Warmann, Stefanie Lang, Frank Fideler, Gunnar Blumenstock, Barbara Schlisio, Matthias Kumpf, Martin Ebinger, Guido Seitz, Jörg Fuchs
JournalJournal of pediatric surgery (J Pediatr Surg) Vol. 49 Issue 4 Pg. 551-5 (Apr 2014) ISSN: 1531-5037 [Electronic] United States
PMID24726111 (Publication Type: Evaluation Study, Journal Article)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Analgesics
Topics
  • Abdominal Neoplasms (surgery)
  • Analgesia, Epidural (methods)
  • Analgesics (therapeutic use)
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Matched-Pair Analysis
  • Pain Measurement
  • Pain, Postoperative (diagnosis, drug therapy, prevention & control)
  • Perioperative Care (methods)
  • Retrospective Studies
  • Treatment Outcome

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