Kerschbaum, G. and Altmeppen, J. and Funk, W. and Taeger, Kai (1998) Parent-controlled analgesia in a 3-year-old boy after traumatic amputation. ANAESTHESIST, 47 (3). pp. 238-242. ISSN 0003-2417,
Full text not available from this repository.Abstract
We report the case of a 3-year-old boy, who received long-term parent-controlled analgesia after traumatic amputation of one leg. He underwent surgery 17 times for a period of 25 days. Parent-controlled analgesia was started four days after admission because analgesia with non-opioid analgetics (acetaminophen) proved to be insuffient. The pump was set to a bolus-dose of 23 mu g kg(-1) piritramide (dipidolor(R)) and a lockout interval of 10 minutes. Permitted maximum cumulative dose in four hours was 5 mg piritramide. There was no continuous infusion of opioid. PCA and possible adverse effects were explained to the mother. A monitoring regimen was used to assess efficacy (pain intensity estimated by the mother), adverse effects (sedation score, occurrence of nausea and vomiting) and piritramide consumption. For fear of side effects opioid administration was insufficient in the beginning. After three days the mother used the PCA effectively and no additional analgesic medication was required. Nausea or other side effects were not observed. After seven days opioid consumption nearly doubled. Apart from tolerance, this might have resulted from the mother's caution in the first days. After 17 days the PCA was discontinued. Oral analgetics (tramadol) controlled the pain adequately. Management of postoperative pain in childrens is difficult and too often insufficient. PCA is a safe and effective method of providing postoperative pain relief. Feasability was shown in adolescents and, more recently, in children aged five years and over. Only few reports are available describing long term use of PCA in children younger than five years. Our case suggests that PCA may also be used effectively and safely in children younger than five years, if experienced staff,a monitoring regimen and cooperative and well instructed parents are available.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PATIENT-CONTROLLED ANALGESIA; LOWER ABDOMINAL-SURGERY; POSTOPERATIVE ANALGESIA; CHILDREN; PAIN; MANAGEMENT; PCA; INFUSIONS; patient-controlled analgesia (PCA); parent-controlled analgesia; pediatric analgesia; opioids |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Sep 2023 09:15 |
| Last Modified: | 12 Sep 2023 09:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/50023 |
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