University thesis:
Dissertation, Universitätsmedizin der Universität Greifswald, 2019
Footnote:
Literaturverzeichnis: Seite 54-61
Description:
caudal epidural morphin
The purpose of this prospective, randomized controlled study was to assess the analgesic effect and safety of caudal epidural morphine (KEM) in post-operative pain control in children after open heart surgery with a sternotomy incision. Materials and methods: Sixty children, 3—14 kg in body weight, undergoing elective cardiac surgery with opioid-based anaesthesia were randomly divided into two treatment groups to receive either 0.06 mg/kg caudal epidural morphine (in a total volume of 0.5 ml/kg in saline) at induction of anaesthesia or control. To standardize the protocol for administration of post-operative rescue paracetamol 15 mg/kg per os and intravenous morphine boluses and infusion (0.05-0.10 mg/kg and 0.025 mg/kg/h, respectively), the Comfort behaviour Skala (CVS) was used. Results: Two patients were excluded from the study after randomization. Twenty-nine patients were enrolled to the KEM group and 29 to the control group. The groups were similar for demographics and intra-operative clinical characteristics. Time from Paediatric Intensive Care Unit (PICU) admission to the start of intravenous morphine was significantly longer (p < 0.0001) in the ITM group compared with the control group (16- 20h vs. 38 min). The total intravenous morphine consumption over the 72 postoperative hours was significantly lower (<0.0001) in the KEM group. Of the 29 patients who received KEM at induction of anesthesia, 20 patients(69,9 %) did not require any additional morphine in the ...