Lidocaine with fentanyl, compared to morphine, marginally improves postoperative epidural analgesia in children.
Can J Anaesth
; 49(1): 67-71, 2002 Jan.
Article
en En
| MEDLINE
| ID: mdl-11782331
PURPOSE: To compare the epidural administration of fentanyl (1 microg/mL) combined with lidocaine 0.4% to preservative-free morphine for postoperative analgesia and side effects in children undergoing major orthopedic surgery. METHODS: In a prospective, double-blind study, 30 children, ASA I-II, 2-16-yr-old, were randomly allocated to receive immediately after surgery either epidural F-L (epidural infusion at a rate of 0.1-0.35 mL/kg/hr of 1 microg/mL of fentanyl and lidocaine 0.4%) or epidural M (bolus of 20 microg/kg of morphine in 0.5 mL/kg saline every eight hours). Both groups received 40 mg/kg of iv metamizol (dipyrone) every six hours. In the F-L Group, blood samples were taken on the second and third postoperative day to determine total lidocaine concentrations. Adequacy of analgesia using adapted pediatric pain scales (0-10 score) and side-effects were assessed every eight hours postoperatively. RESULTS: Resting pain scores were under 4, 95% of the time in the F-L Group and 87% of the time in the M Group (Chi square=4.674, P <0.05). The frequency of complications was very similar in both groups. The F-L Group total plasma lidocaine concentrations were directly related to the dose received, and below the toxic range in all patients. CONCLUSIONS: Postoperative epidural fentanyl with lidocaine infusion provides slightly better analgesia than conventional bolus administration of epidural morphine. Side-effects or risk of systemic toxicity were not augmented by the addition of lidocaine to epidural opioids.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Analgesia Epidural
/
Fentanilo
/
Analgésicos Opioides
/
Anestésicos Locales
/
Lidocaína
/
Morfina
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Can J Anaesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2002
Tipo del documento:
Article
País de afiliación:
España
Pais de publicación:
Estados Unidos