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Medical Science Monitor
Article . 2011 . Peer-reviewed
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Medical Science Monitor
Article
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PubMed Central
Article . 2011
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Epidural and opioid analgesia following the Nuss procedure

Authors: Walaszczyk, Malgorzata; Knapik, Piotr; Misiolek, Hanna; Korlacki, Wojciech;

Epidural and opioid analgesia following the Nuss procedure

Abstract

Parents have the right to decide on behalf of their children and deny consent to regional anaesthesia. The investigators decided to investigate quality of postoperative analgesia in adolescents undergoing epidural and opioid analgesia following the Nuss procedure. material/methods: The study subjects were 61 adolescents aged 11-18 years who underwent pectus excavatum repair with the Nuss procedure. Patients were divided into epidural (n=41) and opioid (n=20) groups, depending on their parents' consent to epidural catheter insertion. Intraoperatively, 0.5% epidural ropivacaine with fentanyl or intermittent intravenous injections of fentanyl were used. Postoperative analgesia was achieved with either epidural infusion of 0.1% ropivacaine with fentanyl, or subcutaneous morphine via an intraoperatively inserted "butterfly" cannula. Additionally, both groups received metamizol and paracetamol. Primary outcome variables were postoperative pain scores (Numeric Rating Scale and Prince Henry Hospital Pain Score). Secondary outcome variables included hemodynamic parameters, additional analgesia and side effects.Heart rate and blood pressure values in the postoperative period were significantly higher in the opioid group. Pain scores requiring intervention were noted almost exclusively in the opioid group.Denial of parental consent to epidural analgesia following the Nuss procedure results in significantly worse control of postoperative pain. Our data may be useful when discussing with parents the available anaesthetic techniques for exceptionally painful procedures.

Keywords

Male, Analysis of Variance, Postoperative Pain, Adolescent, Morphine, Dipyrone, Blood Pressure, Amides, Statistics, Nonparametric, Analgesia, Epidural, Analgesics, Opioid, Fentanyl, Heart Rate, Funnel Chest, Humans, Minimally Invasive Surgical Procedures, Female, Parental Consent, Ropivacaine, Public Health, Pain Measurement

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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
20
Top 10%
Top 10%
Average
Green
gold