Title Lumbar Versus Thoracic Epidural Catheter for Post-Thoracotomy Analgesia

Bodily, Mark N.; Chamberlain, D. P.; Ramsey, Donald; Olsson, G. L.

doi:10.1097/00000542-198909001-01146

Cited by 13 publications

(1 citation statement)

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“…The administration of lipophilic opioid for optimal postoperative analgesia needs catheter placement at or near the level of surgery. Bodily et al ( 12) demonstrated that higher doses of fentanyl were required to achieve equal analgesia with lumbar than thoracic epidural levels. The higher doses resulted in higher systemic levels, related to uptake by epidural vasculature, which may lead to adverse effects ( 13).…”

Section: Discussionmentioning

confidence: 99%

Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery

Goodarzi

1999

Pediatric Anesthesia

113

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The safety and side-effects profile of epidural administration of a hydrophilic (morphine), highly lipophilic (fentanyl) and a drug with intermediate hydrophilic and lipophilic activity (hydromorphone) were compared in 90 children undergoing orthopaedic procedures. Ninety patients were randomly assigned (30 in each group) to receive epidural morphine, hydromorphone, or fentanyl for postoperative analgesia. Respiratory effects, nausea, somnolence, urinary retention, pruritus and visual pain scales were evaluated and compared during a 30-h period following surgery. In the morphine group, 25% showed respiratory depression with oxygen saturation below 90% but there was no incidence of respiratory depression in the fentanyl or hydromorphone groups. Somnolence was prominent in some of the patients in all the groups, but was more prolonged in the morphine group. Statistically, there was no significant difference in nausea between the groups, but pruritus was more severe and frequent in the morphine group. The incidence of urinary retention in the morphine group was higher compared with the fentanyl and hydromorphone groups. In conclusion, epidural hydromorphone, demonstrating less side-effects, is preferable to morphine and fentanyl for epidural analgesia in children.

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Section: Discussionmentioning

confidence: 99%

Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery

Goodarzi

1999

Pediatric Anesthesia

113

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Analgésie péridurale postopératoire

Vercauteren

1994

Douleur analg

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Thoracic epidural anaesthesia in infants and children

Tobias

Löwe²,

O'Dell³

et al. 1993

Can J Anaesth

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Accepted for publication 20th April, 1993. In children, postoperative analgesia is generally provided by either parenteral narcotics or regional anaesthetic techniques such as epidural anaesthesia. Although the efficacy of epidural anaesthesia in providing postoperative analgesia in children has been demonstrated, i-3 these studies have utilized either caudal or lumbar placement of the epidural catheter. The majority of experience with thoracic epidural analgesia in children has involved catheter placement from the caudal approach. 4-6Our review of the literature has found only three previous reports concerning the use of epidural catheters placed at the thoracic level for postoperative analgesia in children. 1,7,8 The earliest of these studies by Meigner et al. 7 demonstrated the safety and efficacy of this technique in eight children. The second study s included 30 CAN J ANAESTH 1993 / 40:9 / pp 879-82

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Title Lumbar Versus Thoracic Epidural Catheter for Post-Thoracotomy Analgesia

Cited by 13 publications

References 0 publications

Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery

Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery

Analgésie péridurale postopératoire

Thoracic epidural anaesthesia in infants and children

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