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Parent-controlled analgesia in children undergoing cleft palate repair

Seung Ho Choi1, Woo Kyung Lee, Sung Jin Lee

  • 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|February 28, 2008
PubMed

Insights

This study determined an effective fentanyl dose for parent-controlled analgesia (PrCA) in children after cleft palate repair. The optimal basal infusion rate of 0.63 microgram/kg/hr achieved high parent satisfaction with postoperative pain management.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Recovery

Background:

  • Postoperative pain management in pediatric cleft palate repair requires effective and safe analgesia.
  • Parent-controlled analgesia (PrCA) offers a patient-centered approach to managing pain in young children.
  • Fentanyl is a potent opioid commonly used for analgesia, but optimal dosing for PrCA needs definition.

Purpose of the Study:

  • To identify an optimal basal infusion dose of fentanyl for parent-controlled analgesia (PrCA) in pediatric cleft palate repair.
  • To assess the level of parental satisfaction with the PrCA modality for postoperative pain control.

Main Methods:

  • An up-and-down method was employed to determine the effective dose of fentanyl (ED50 and ED95) for PrCA.
  • Thirty children (6 months–2 yr) received fentanyl via PrCA post-cleft palate repair.
  • Parents were educated on PrCA device use, pain scoring, and adverse effect monitoring.

Main Results:

  • The estimated 50% effective dose (ED50) of fentanyl was 0.63 microgram/kg/hr.
  • The estimated 95% effective dose (ED95) of fentanyl was 0.83 microgram/kg/hr.
  • Eighty-seven percent of parents reported satisfaction with the PrCA method.

Conclusions:

  • Parent-controlled analgesia with fentanyl at a basal infusion rate of 0.63 microgram/kg/hr is effective for postoperative pain management in children undergoing cleft palate repair.
  • PrCA with this fentanyl regimen demonstrates a high level of parental satisfaction.
  • This approach provides a safe and effective option for pediatric postoperative pain control.

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