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Titolo:
Epidural analgesia in children with cerebral palsy
Autore:
Brenn, BR; Brislin, RP; Rose, JB;
Indirizzi:
Alfred,I duPont Hosp Children, Editorial Serv, Dept Anesthesiol, Wilmington Alfred I duPont Hosp Children Wilmington DE USA 19899 thesiol, Wilmington Childrens Hosp Philadelphia, Dept Anesthesiol, Philadelphia, PA 19104 USA Childrens Hosp Philadelphia Philadelphia PA USA 19104 lphia, PA 19104 USA
Titolo Testata:
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
fascicolo: 12, volume: 45, anno: 1998,
pagine: 1156 - 1161
SICI:
0832-610X(199812)45:12<1156:EAICWC>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTOPERATIVE PAIN RELIEF; URINARY-TRACT DYSFUNCTION; BUPIVACAINE; ANESTHESIA; INFUSION; INFANTS; LUMBAR;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Brenn, BR Alfredilmington,Hosp Children, Editorial Serv, Dept Anesthesiol,POB 269, W Alfred I duPont Hosp Children POB 269 Wilmington DE USA 19899 W
Citazione:
B.R. Brenn et al., "Epidural analgesia in children with cerebral palsy", CAN J ANAES, 45(12), 1998, pp. 1156-1161

Abstract

Purpose: Two modalities of epidural analgesia in children with two types of cerebral palsy (CP) were compared for differences in the incidence of common complications (inadequate analgesia, hypopnea, hypoxaemia, sedation, vomiting, pruritus, urinary retention, and seizures). Methods: Demographic, procedural and postoperative complication data were collected on children with CP receiving epidural analgesia. Information wasrecorded contemporaneously with the child's care by one of the authors on 92 consecutive children with CP(age, 107 +/- 50.1 mo; weight, 26 +/- 14.2 kg) who had undergone infra-umbilical orthopaedic or Nissen fundoplication procedures between December 1994 and December 1996. The first 44 patients received intermittent bolus (IB) epidural morphine and the next 48 received continuous infusion (CI) bupivacaine and fentanyl. Two forms of CP (spastic diplegia and quadriplegia) and the two modalities of analgesia were compared. Results: Excellent analgesia was obtained in 91/92 patients. Excessive sedation occurred in six patients (6.5%) but only in IB patients, (P < 0.02 vsCI). Emesis occurred in 52% of patients, and was more common in diplegic than in quadriplegic patients (68% vs 38%, P < 0.01). Pruritus was observed in 29% of patients and was more common in diplegia than quadriplegia (48% vs 12.5%, P < 0.001). The incidences hypopnea, hypoxaemia, urinary retentionand seizures were not affected by the types of CP or analgesia and no difference in sedation was observed between spastic diplegic and quadriplegic patients. Conclusions: Continuous infusion of epidural bupivacaine and fentanyl provided excellent analgesia for children with CP without serious complications. Intermittent bolus epidural morphine was associated with a high incidenceof excessive sedation and should be avoided in this population.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 11:48:46