What is it about?
Post-Operative Pain Relief in Children undergoing Thoracic and Upper Abdominal Surgeries
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Why is it important?
Background and aims: Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, rapid weaning from ventilators, lowered circulating stress hormone levels. Precise placement of epidural catheters ensures selective blockade of dermatomes affected by surgical procedure, allowing reduction of doses of local anaesthetics and additional analgesics. The aim of the study was to analyse efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery. Methods: This was prospective observational study carried out for a year, total of 44 paediatric patients who underwent thoracoabdominal surgery under general anaesthesia with epidural analgesia were considered and studied for general practice in our institute for epidural catheter placement, efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery, complications of epidural catheter placement.Data were expressed as means (with standard deviations) and percentages (for categorical data). Unpaired t test and chi square test were used to compare continuous and categorical data respectively. Results: The total volume of local anaesthetic required in first 24 hrs postoperative in congruent group was 6.67±2.56ml/kg as compared to 8.60±2.938ml/kg incongruent group (p=0.025). In congruent group 16% of children required additional analgesic as compared to incongruent group where 36.84% of children required additional analgesics. Conclusion: Our study shows that putting the epidural catheter congruent to surgical incision required less of volume of local anaesthetic and additional analgesics and should be practiced preferably.
Perspectives
Background and aims: Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, rapid weaning from ventilators, lowered circulating stress hormone levels. Precise placement of epidural catheters ensures selective blockade of dermatomes affected by surgical procedure, allowing reduction of doses of local anaesthetics and additional analgesics. The aim of the study was to analyse efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery. Methods: This was prospective observational study carried out for a year, total of 44 paediatric patients who underwent thoracoabdominal surgery under general anaesthesia with epidural analgesia were considered and studied for general practice in our institute for epidural catheter placement, efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery, complications of epidural catheter placement.Data were expressed as means (with standard deviations) and percentages (for categorical data). Unpaired t test and chi square test were used to compare continuous and categorical data respectively. Results: The total volume of local anaesthetic required in first 24 hrs postoperative in congruent group was 6.67±2.56ml/kg as compared to 8.60±2.938ml/kg incongruent group (p=0.025). In congruent group 16% of children required additional analgesic as compared to incongruent group where 36.84% of children required additional analgesics. Conclusion: Our study shows that putting the epidural catheter congruent to surgical incision required less of volume of local anaesthetic and additional analgesics and should be practiced preferably.
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This page is a summary of: A Prospective Observational Study – Epidural Catheter Insertion Site and Adequacy of Post-Operative Pain Relief in Children undergoing Thoracic and Upper Abdominal Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51018.4.
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