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Updated: May 1, 2026

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

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

Published on: January 28, 2010

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Epidural analgesia for postoperative pain control in children

M D Jones1, D D Aronsson, J M Harkins

  • 1Medical Center Hospital, Fletcher Allen Health Care, Burlington, Vermont, USA.

Journal of Pediatric Orthopedics
|July 14, 1998
PubMed

Insights

Continuous epidural analgesia effectively manages pediatric postoperative pain. Adding fentanyl to bupivacaine epidurals significantly reduces the need for supplemental systemic narcotics, enhancing pain control.

Area of Science:

  • Anesthesiology
  • Pediatric Pain Management
  • Pharmacology

Background:

  • Postoperative pain in children requires effective management.
  • Continuous epidural analgesia is a viable option for pediatric pain control.
  • Optimizing epidural regimens can improve patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of continuous postoperative epidural analgesia in children.
  • To compare the effectiveness of bupivacaine alone versus bupivacaine with fentanyl for epidural analgesia.
  • To assess the impact of fentanyl addition on the requirement for supplemental systemic analgesia.

Main Methods:

  • Ninety-eight continuous epidural infusions were administered to 87 pediatric patients.
  • Group I received bupivacaine (0.0625-0.25%) alone.
  • Group II received bupivacaine with fentanyl (2-10 micrograms).
  • Doses were titrated by anesthesiologists based on patient age and anticipated pain.
  • Pain scores and supplemental analgesia requirements were recorded for 48 hours.

Main Results:

  • The overall average pain score for the first 48 hours was 1.43.
  • Supplemental analgesia was required in 49 cases (41 in Group I, 8 in Group II).
  • Group I required an average of 0.144 mg/kg/8h of intravenous morphine.
  • Group II required significantly less supplemental analgesia, averaging 0.056 mg/kg/8h of intravenous morphine.

Conclusions:

  • Continuous epidural analgesia is an effective method for managing postoperative pain in children.
  • The addition of fentanyl to continuous epidural bupivacaine significantly reduces the need for systemic opioid analgesics.
  • This combination therapy offers improved pain control and potentially fewer systemic side effects.

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