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Efficacy of Epidural Analgesia after Laparotomy in Children

Klarieke Bravenboer-Monster1, Claudia Keyzer-Dekker1, Monique van Dijk1

  • 1Department of Pediatric Surgery, ErasmusMC-Sophia Children's Hospital, Rotterdam, The Netherlands.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|February 20, 2018
PubMed

Insights

Epidural analgesia (EDA) provided effective postoperative pain relief in 65% of children after laparotomy. This study found low rates of adverse effects and complications, suggesting EDA is a viable option for pediatric surgical pain management.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Pain Management

Background:

  • Epidural analgesia (EDA) is utilized for pediatric postoperative pain, yet its effectiveness following laparotomy remains under-researched.
  • This study retrospectively evaluated the efficacy of EDA in children undergoing laparotomy and assessed adverse events.

Purpose of the Study:

  • To determine the success rate of postoperative epidural analgesia in children after laparotomy.
  • To identify the incidence of adverse effects and complications associated with EDA in this patient population.

Main Methods:

  • A retrospective analysis of children (0-18 years) who received EDA post-laparotomy between January 2014 and December 2015.
  • Success was defined by catheter removal when no longer needed or continuation after intervention; data on interventions, early removal, and adverse events were collected.

Main Results:

  • Of 90 children (median age 3.7 years), 65% experienced successful EDA. Younger children had significantly higher success rates (p=0.003).
  • 35% of cases required early catheter removal, often due to inadequate pain relief or technical issues. Adverse effects were reported in 18% and complications in 1% of patients.

Conclusions:

  • Postoperative epidural analgesia offers beneficial pain management for approximately two-thirds of pediatric patients undergoing laparotomy.
  • The incidence of adverse effects and complications was low, supporting EDA as a safe option. Further research should focus on optimizing EDA and comparing it with alternative analgesia techniques.
Abstract

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