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Sacroepidural analgesia for post-operative pain relief in children
1Department of Anesthesiology, Venterans General Hospital-Taipei, National Yang-Ming Medical College.
Insights
Sacroepidural analgesia using bupivacaine effectively manages post-operative pain in children undergoing lower abdominal surgery. A single dose of 1.0 mL/kg provided safe and sufficient pain relief for approximately six hours.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Regional Anesthesia
Background:
- Post-operative pain management in pediatric surgery is crucial for patient recovery.
- Epidural analgesia offers a potential solution for effective pain relief.
- Evaluating specific anesthetic agents and dosages is necessary for pediatric application.
Purpose of the Study:
- To assess the efficacy and safety of sacroepidural bupivacaine for post-operative pain relief in pediatric patients.
- To determine the optimal dosage of 0.25% bupivacaine for surgeries below the lower abdomen in children.
- To evaluate the duration and quality of analgesia provided by sacroepidural bupivacaine.
Main Methods:
- A study involving 66 pediatric patients (6 months to 12 years) undergoing elective lower abdominal surgery.
- Patients were divided into five groups, receiving varying single doses of 0.25% bupivacaine via sacroepidural injection.
- Dosages ranged from 0.25 mL/kg to 1.25 mL/kg (ideal body weight).
Main Results:
- A sacroepidural dose of 1.0 mL/kg of 0.25% bupivacaine was found sufficient for post-operative pain relief.
- This dosage achieved a T8-T6 neural block and provided analgesia lasting approximately 6.0 ± 2.1 hours.
- No adverse effects, including hypotension, bradycardia, vomiting, or shivering, were observed.
Conclusions:
- Sacroepidural analgesia with a single dose of 0.25% bupivacaine is a safe and feasible option for post-operative pain management in children.
- The determined optimal dose of 1.0 mL/kg is effective for surgical procedures below the lower abdomen.
- This technique offers a promising approach to pediatric pain control with minimal side effects.
Abstract:
For evaluation of the practicality of epidural analgesia for alleviation of post-operative pain, 66 class I or II patients with age ranging from 6 months to 12 years undergoing elective surgical procedures below the lower abdomen were enrolled for study during the period from January to April 1989. Before termination of general anesthesia a single dose of 0.25% bupivacaine, respectively at 0.25 mL/kg (Ideal body weight), 0.5 mL/kg, 0.75 mL/kg, 1.0 mL/kg and 1.25 mL/kg was given sacroepidurally to 5 groups of patients. Our results showed that for surgery below the lower abdomen a dose at 1.0 mL/kg was sufficient to suffice the need for relief of post-operative pain. At this dosage it achieved a neural block up to T8-T6 and provided with an analgesia that could last 6.0 +/- 2.1 hours. During the entire course there were no untoward effects such as hypotension, bradycardia, vomiting and shivering to come about. Therefore, sacroepidural analgesia with 0.25% bupivacaine at fitting single dose is safe and feasible in children as far as relief of post-operative pain for procedures below the lower abdomen is concerned.