Perioperative pain management in major reconstructive surgery in pediatric urology

Rubenwolf, P. C. and Koller, B. and Ruebben, I. and Ebert, A. -K. and Pohl, F. and Roesch, W. H. (2011) Perioperative pain management in major reconstructive surgery in pediatric urology. UROLOGE, 50 (5). 566-+. ISSN 0340-2592,

Full text not available from this repository. (Request a copy)

Abstract

Regional analgesia is firmly established in modern pediatric anesthetic practice and its popularity continues to grow. In our department continuous epidural anesthesia (CEA) is a frequently used technique of pain management following major reconstructive procedures of the lower urinary tract. The aim of this study was to investigate the efficacy, safety, and potential benefits of CEA over standard analgesics. We retrospectively reviewed the records of 21 infants who underwent single-stage bladder exstrophy repair in our department. In 15 children an epidural catheter was placed preoperatively for CEA; 6 patients treated without CEA served as controls. Total doses of narcotics and analgesics, length of intensive care unit (ICU) stay and ventilatory assistance, time to first bowel activity, anticholinergic requirements, and CEA-related side effects were documented and compared for both groups. Children given epidural anesthesia required six- to tenfold lower doses of morphine intra- and postoperatively compared to those without CEA; ventilatory support upon completion of surgery was remarkably shorter (59 versus 210 min) in the CEA group as well as ICU stay (1.1 versus 1.8 days). The total consumption of anticholinergics was twice as high as in patients without CEA. There were no relevant CEA-related complications. Being a retrospective audit of practice in our institution with a small number of patients, our results are in line with previously published data on CEA in pediatric patients. CEA has been shown to significantly reduce the need for anesthetics and morphine and allows early extubation with all subsequent advantages for a speedy recovery post surgery. Thus, the technique is to be recommended as a safe and efficacious method for pain management following major reconstructive surgery in pediatric urology. Importantly, this type of anesthesia should be performed only by experienced anesthesiologists in institutions where appropriate equipment, staff, and monitoring are available.

Item Type: Article
Uncontrolled Keywords: EPIDURAL ANALGESIA; ANESTHESIA; CHILDREN; Peridural anaesthesia; Perioperative pain management; Bladder exstrophy; Reconstructive surgery; Pediatric urology
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Urologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 18 Jun 2020 08:02
Last Modified: 18 Jun 2020 08:02
URI: https://pred.uni-regensburg.de/id/eprint/20872

Actions (login required)

View Item View Item