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Lumbar epidural morphine for postoperative analgesia in children undergoing Nuss procedure

Kariya, N.; Inoue, Y.; Minami, W.; Ikeda, Y.; Nishi, S.; Nishikawa, K.; Asada, A.

Masui. Japanese Journal of Anesthesiology 54(5): 496-499

2005

ISSN/ISBN: 0021-4892
PMID: 15915747
Document Number: 587742
Background: We examined the effects of lumbar epidural morphine for postoperative analgesia in children after the Nuss procedure for funnel chest.Methods: An epidural catheter was inserted from the L 3-4 interspace preoperatively (epidural group). Epidural morphine 30 mu g . kg(-1) was given at the beginning of the operation. Postoperatively, epidural morphine 3 mu g . kg(-1) . hr(-1) was infused. The frequency of demand for postoperative analgesia was retrospectively compared with that of children who had not received epidural morphine (control group).Results: On the 0(th) postoperative day, the epidural group required fewer analgesics than the control group (0.50 +/- 0.30 vs. 2.50 +/- 1.00 . day(-1)). However, after the 1(st) postoperative day, the demand for analgesia did not differ between the two groups.Conclusions: Epidural morphine 30 mu g . kg(-1) given at the beginning of operation provided effective analgesia on the 0(th) postoperative day after the Nuss procedure. However, epidural infusion of morphine 3 mu g . kg(-1) . hr(-1) was not effective after the 1(st) postoperative day. Further study is needed to determine the lumbar epidural infusion dose of morphine adequate for use after the Nuss procedure.

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