[Patient-controlled analgesia in children]

Area of Science:

• Pediatric Anesthesiology
• Pain Management
• Orthopedic Surgery

Context:

• Postoperative pain management in pediatric orthopedic surgery presents unique challenges.
• Patient-controlled analgesia (PCA) offers a potential solution for effective pain relief.
• Morphine is a common analgesic agent for moderate to severe pain.

Purpose:

• To evaluate the initial experience and efficacy of patient-controlled analgesia (PCA) using morphine for postoperative pain control in school-aged children.
• To determine optimal morphine dosage regimens for both continuous infusion and PCA modes in this pediatric population.
• To assess the safety and side effect profile of PCA with morphine in pediatric orthopedic patients.

Summary:

• Thirty school-aged children undergoing major orthopedic surgery received morphine via patient-controlled analgesia (PCA).
• Initial dosage regimens were adjusted after the first eight patients, leading to satisfactory analgesia and few side effects in the subsequent 20 patients.
• Recommended morphine dosages include a loading dose of 0.1-0.2 mg/kg, a continuous infusion rate of 0.01-0.02 mg/kg/h, and a PCA bolus dose of 0.01-0.02 mg/kg.

Impact:

• Demonstrates the feasibility and effectiveness of PCA with morphine for managing acute postoperative pain in pediatric orthopedic patients.
• Provides evidence-based recommended dosage ranges for morphine administration via PCA in children.
• Highlights the importance of individualized dosage titration for optimizing pain control and minimizing adverse events in pediatric PCA therapy.