JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Rosen, D. A. Articles by Gustafson, R. A. Search for Related Content PubMed PubMed Citation Articles by Rosen, D. A. Articles by Gustafson, R. A.

---

PEDIATRIC ANESTHESIA

Analgesia for Pediatric Thoracostomy Tube Removal

David A. Rosen, MD^*,, John L. Morris, BS^*, Kathleen R. Rosen, MD^*, Roberto C. Valenzuela, MD^*, Michele G. Vidulich, PA, Robert J. Steelman, MD, and Robert A. Gustafson, MD^,

Departments of *Anesthesia, Pediatrics, and Surgery, West Virginia University Children’s Hospital, West Virginia University, Morgantown, West Virginia

Address correspondence and reprint requests to David A. Rosen, MD, Department of Anesthesiology, 3618 Health Sciences Center, Box 9134, Morgantown, WV 26506-9134.

Eutectic mixture of local anesthetics (EMLA®; Astra Pharmaceuticals, Wayne, PA) has been shown to reduce the pain of blood draws in children. We investigated the use of EMLA® versus IV morphine for providing analgesia during chest tube removal (CTR) in children. One hundred twenty pediatric cardiothoracic surgery patients were enrolled. Patients were randomly assigned to receive either morphine (0.1 mg/kg up to 10 mg IV 30 min before CTR) or EMLA® cream (5 g per chest tube cutaneously 3 h before CTR). A single, trained observer rated the patient’s pain before, during, and after CTR using a 10-cm visual analog scale. The sites were evaluated for adverse effect. Methylhe-moglobin levels were monitored in infants. Before CTR, the pain scores of the children who received morphine were rated lower than those who received EMLA® (P < 0.01). During CTR, there was no difference in the pain score between the morphine or EMLA® group. The change from baseline pain score in the morphine group was significantly larger than in the EMLA® group (P < 0.01). We conclude that EMLA® is safe and useful for blunting the pain of CTR.

Implications: Chest tube removal is one of the most painful parts of the cardiothoracic surgical experience. This study compared EMLA® (Astra Pharmaceuticals, Wayne, PA) cream to morphine in providing pain relief for chest tube removal. EMLA® can be used as a useful means of controlling the pain of chest tube removal.

This article has been cited by other articles:

				American Academy of Pediatrics, Committee on Fetus and Newborn and Section on Surg, Canadian Paediatric Society, and Fetus and Newborn Committee Prevention and Management of Pain in the Neonate: An Update Pediatrics, November 1, 2006; 118(5): 2231 - 2241. [Abstract] [Full Text] [PDF]

				I M Balfour-Lynn, E Abrahamson, G Cohen, J Hartley, S King, D Parikh, D Spencer, A H Thomson, D Urquhart, and on behalf of the Paediatric Pleural Diseases Subco BTS guidelines for the management of pleural infection in children Thorax, February 1, 2005; 60(suppl_1): i1 - i21. [Full Text] [PDF]

				J. Barnard, J. Thompson, and J. Dunning Can any intervention effectively reduce the pain associated with chest drain removal? Interactive CardioVascular and Thoracic Surgery, June 1, 2004; 3(2): 229 - 232. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999