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Erschienen in:
01.07.2010 | Original Article
Systemic postoperative pain management following minimally invasive pectus excavatum repair in children and adolescents: a retrospective comparison of intravenous patient-controlled analgesia and continuous infusion with morphine
Erschienen in: Pediatric Surgery International | Ausgabe 7/2010
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Purpose
Optimal postoperative pain management following minimally invasive surgical repair of pectus excavatum is not established. We compared efficacy and adverse effects in patients treated with patient-controlled analgesia (PCA) with those treated with continuous infusion (CI) with morphine in addition to nonsteroidal anti-inflammatory drugs.
Methods
33 patient records were examined retrospectively: 21 given PCA and 12 CI with morphine. Main outcome variables were used doses of morphine, pain scores every 3 h and adverse effects.
Results
Median (range) used morphine dose was 0.58 (0.21–1.12) and 0.52 (0.34–0.84) mg/kg on the day 1 and 0.3 (0.02–0.6) and 0.33 (0.09–0.53) mg/kg on the day 2 in PCA and CI groups, respectively (p > 0.05). Pain scores were within moderate and low levels during 42 h after surgery and did not differ between the groups. Median (range) oxygen saturation was 96.5 (93–100) and 97 (94–100) in PCA and CI groups, respectively (p > 0.05). Additional oxygen therapy was required in 14.3% in PCA group and 25% in CI group (p > 0.05). The incidence of pulmonary adverse effects was rare and did not differ between the groups.
Conclusion
Both methods of systemic analgesia in addition to non-opioid analgesics were equally effective and resulted in a low incidence of pulmonary adverse effects.