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[Patient-controlled analgesia in children]
T G Hansen1, S W Henneberg, P Hole
1Anaestesi- og intensiv afdeling V, Odense Sygehus.
Insights
Patient-controlled analgesia (PCA) effectively manages pain in children after surgery. This method provides safe and high-quality pain relief with minimal side effects in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Context:
- Introduction of intravenous patient-controlled analgesia (PCA) in pediatric care.
- Evaluation of PCA in children undergoing major orthopedic or abdominal surgery.
- Implementation at Odense University Hospital's Department of Anaesthesiology and Intensive Care.
Purpose:
- To assess the efficacy and safety of intravenous PCA for pediatric postoperative pain management.
- To determine appropriate morphine dosage and administration parameters for children.
- To evaluate patient-reported pain scores and observed side effects.
Summary:
- The study involved 13 children (ages 4-15) receiving PCA with morphine post-surgery.
- Initial settings included a 25 mcg/kg bolus dose and an 8-minute lockout interval.
- Average morphine consumption was 9.5 mcg/kg/hour over a mean of 89 postoperative hours.
- Pain control was rated as good with few minor side effects.
Impact:
- Demonstrates PCA as an effective and safe method for providing quality analgesia in children.
- Highlights the successful integration of PCA into pediatric surgical care.
- Provides data supporting the use of PCA for postoperative pain in pediatric populations.
Abstract:
In order to introduce intravenous patient-controlled analgesia (PCA) in children in the Department of Anaesthesiology and Intensive Care, Odense University Hospital, we evaluated the technique in 13 children following major orthopaedic or abdominal surgery. The pump (Pharmacia-Deltec, CADD-PCA) was loaded with 1 mg/ml morphine in a 50 milliliters cassette. A bolus dose of 25 micrograms/kg and a lock-out interval of eight minutes were the initial settings. The morphine dose used, pain scores and side effects were currently recorded. Ages ranged from 4-15 years (mean 10.5 years) and the method was used for a mean of 89 hours (range 57-144 hours) postoperatively. Morphine requirements averaged 9.5 microgram/kg/hour (range 5.4-15.6 microgram/kg/hour). Pain control was good and side effects were few and of minor nature. PCA is an effective and safe means of providing good quality analgesia in children.