Related Experiment Videos
Epidural versus patient-controlled analgesia with morphine for postoperative pain after orthopaedic procedures in
M Goodarzi1, N H Shier, J A Ogden
1Shriners Hospital for Crippled Children, Tampa, FL 33612.
Insights
Intermittent epidural morphine (EM) and patient-controlled analgesia provided similar pain relief for children after orthopaedic surgery. Both methods showed no significant differences in pain scores or quality of relief.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Effective postoperative pain management is crucial for pediatric patients undergoing orthopaedic surgery.
- Patient-controlled analgesia (PCA) and epidural analgesia are common methods for managing surgical pain.
Purpose of the Study:
- To compare the clinical effectiveness of intermittent epidural morphine (EM) versus patient-controlled analgesia (PCA) for pain relief in children post-orthopaedic surgery.
- To determine if EM offers a significant advantage over PCA in pediatric pain management.
Main Methods:
- A randomized controlled trial involving 40 pediatric patients undergoing orthopaedic surgery.
- Patients were allocated to receive either intermittent epidural morphine (EM) or PCA with morphine.
- Postoperative pain levels were assessed using a standardized objective pain scale by trained observers for the first 30 hours.
Main Results:
- No significant differences were observed in patient demographics (age, weight) or surgical factors (operation duration, anesthesia).
- Both EM and PCA groups reported comparable quality of pain relief.
- There were no significant differences in the incidence of side effects between the two groups.
Conclusions:
- Intermittent epidural morphine (EM) does not offer a significant clinical advantage over patient-controlled analgesia (PCA) for pediatric patients after orthopaedic surgery.
- Both EM and PCA are effective methods for managing postoperative pain in children, with similar outcomes regarding pain scores and side effects.
Abstract:
We compared epidural and patient-controlled analgesia using morphine for pain relief during the first 30 h after orthopaedic surgery to examine whether intermittent epidural morphine (EM) offered a clinical advantage over patient-controlled analgesia in children. Forty patients were assigned randomly to receive either EM or morphine by the patient-controlled analgesia technique. In the special care unit, trained observers evaluated the patient's level of postoperative pain with a standardized objective pain scale. The differences in pain scores among the groups were compared. The two groups were not significantly different in age, weight, duration of operation, or anesthesia. There was no significant difference in quality of pain relief except for the amount of medicine required to control postoperative pain and the incidence of side effects between the two groups.