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 (11) Citing Articles via Google Scholar Google Scholar Articles by Antok, E. Articles by Chassard, D. Search for Related Content PubMed PubMed Citation Articles by Antok, E. Articles by Chassard, D. Related Collections Pediatrics Regional Anesthesia Pain Pharmacology

---

PEDIATRIC ANESTHESIA

Patient-Controlled Epidural Analgesia Versus Continuous Epidural Infusion with Ropivacaine for Postoperative Analgesia in Children

Emmanuel Antok, MD^*, Fabienne Bordet, MD^*, Frédéric Duflo, MD^*, Sabine Lansiaux, MD^*, Sylvie Combet, MD^*, Patricia Taylor, MD^*, Agnes Pouyau, MD^*, Brigitte Paturel, MD^*, Robert James, MS, Bernard Allaouchiche, MD PhD^*, and Dominique Chassard, MD PhD^*

*Service d’Anesthésie-Réanimation, Hôpital de l’Hôtel-Dieu et Debrousse, Lyon, France; and Department of Anesthesiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina

Address correspondence and reprint requests to Dominique Chassard, MD, PhD, Service d’Anesthésie-Réanimation, Hôpital de l’Hôtel-Dieu, 69002, Lyon, France. Address e-mail to dominique.chassard{at}chu-lyon.fr

Epidural ropivacaine infusion has been used in children; however, patient-controlled epidural analgesia (PCEA) has not been evaluated in the pediatric population. In this study, we compared the clinical efficiency of PCEA and of continuous epidural infusion analgesia (CEA) in children. Forty-eight children undergoing orthopedic surgery were randomized to receive PCEA or CEA with ropivacaine 0.2%. All patients underwent a standard general anesthetic. Children also received ketoprofen and propacetamol. Pain scores and side effects were recorded for 48 h. If the visual analog score scale score was >4 of 10, analgesia was considered inadequate, and rescue treatment was administered. Both groups obtained effective pain relief. Children in the PCEA group received significantly less local anesthetic than those in the CEA group (0.20 ± 0.08 mg · kg^-1 · h^-1 versus 0.40 ± 0.08 mg · kg^-1 · h^-1; P < 0.001). Motor effects, supplemental analgesic requirements, and side effects did not differ. We concluded that PCEA with ropivacaine 0.2% can provide adequate postoperative analgesia for pediatric orthopedic procedures with smaller dose requirements than CEA.

IMPLICATIONS: We studied patient-controlled epidural analgesia (PCEA) and continuous epidural infusion analgesia (CEA) with 0.2% ropivacaine during the postoperative period in children. We found that either PCEA or CEA with plain ropivacaine 0.2% provided adequate pain relief in children during the first 48-h postoperative course. However, adequate analgesia was obtained with 50% less volume infused with PCEA compared with CEA.

This article has been cited by other articles:

				F. Duflo, V. Sautou-Miranda, A. Pouyau, P. Taylor, S. Combet, F. Chotel, N. Bleyzac, and D. Chassard Efficacy and plasma levels of ropivacaine for children: controlled regional analgesia following lower limb surgery Br. J. Anaesth., August 1, 2006; 97(2): 250 - 254. [Abstract] [Full Text] [PDF]

				C. Dadure, S. Bringuier, F. Nicolas, L. Bromilow, O. Raux, A. Rochette, and X. Capdevila Continuous epidural block versus continuous popliteal nerve block for postoperative pain relief after major podiatric surgery in children: a prospective, comparative randomized study. Anesth. Analg., March 1, 2006; 102(3): 744 - 749. [Abstract] [Full Text] [PDF]

				F. Duflo, Y. Qamouss, C. Remond, A. Pouyau, A. Heilporn, P. Taylor, B. Paturel, S. Combet, E. Boselli, F. Chotel, et al. Patient-controlled regional analgesia is effective in children: a preliminary report: [L'analgesie regionale auto-controlee est efficace chez les enfants : une etude preliminaire] Can J Anesth, November 1, 2004; 51(9): 928 - 930. [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