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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
14:56

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Published on: January 27, 2010

Postoperative extradural analgesia in children: comparison of morphine with fentanyl

C Lejus1, G Roussière, S Testa

  • 1Departement d'Anesthésie, Hôtel-Dieu, Nantes, France.

British Journal of Anaesthesia
|February 1, 1994
PubMed

Insights

Extradural fentanyl provided effective postoperative pain relief in children, comparable to morphine but with fewer side effects like nausea and vomiting. This suggests fentanyl is a safer option for pediatric pain management.

Area of Science:

  • Anesthesiology
  • Pediatric Pain Management
  • Pharmacology

Background:

  • Postoperative pain management in children is crucial for recovery.
  • Extradural analgesia is a common method for managing severe pain.
  • Comparing different analgesic agents is essential for optimizing patient care.

Purpose of the Study:

  • To compare the efficacy and side effects of extradural morphine versus extradural fentanyl for postoperative pain relief in children.
  • To evaluate pain scores, respiratory function, and adverse events in both treatment groups.

Main Methods:

  • A randomized study involving 30 children (ages 1-16 years) undergoing surgery.
  • Group M received extradural morphine bolus followed by a second dose 24 hours later.
  • Group F received extradural fentanyl bolus followed by a continuous extradural infusion for 48 hours.

Main Results:

  • Both extradural morphine and fentanyl provided satisfactory pain relief for 48 hours without major respiratory depression.
  • Children receiving fentanyl experienced significantly less pruritus, nausea, and vomiting compared to morphine.
  • Ventilatory frequency was higher in the morphine group at several time points post-analgesia.

Conclusions:

  • Continuous extradural fentanyl infusion offers comparable analgesia to daily extradural morphine boluses in children.
  • Extradural fentanyl is associated with a lower incidence of side effects, making it a potentially preferable option for pediatric postoperative pain management.

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