| Title | The addition of fentanyl to 1.5 mg/ml ropivacaine has no advantage for paediatric epidural analgesia. | | Author(s) | Cho JE, Kim JY, Hong JY, Kil HK | | Institution | Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. | | Source | Acta Anaesthesiol Scand 2009 Jun 30. | | Abstract | Background: Epidural opioids are frequently combined with local anaesthetics for an additive antinociceptive effect. We investigated the efficacy of epidural fentanyl to 1.25 or 1.5 mg/ml ropivacaine for post-operative epidural analgesia in children.
Methods: One hundred and eight children undergoing hypospadias repair were randomized to receive 1.25 mg/ml ropivacaine (R(1.25) group), 1.25 mg/ml ropivacaine with 0.2 mcg/kg/h of fentanyl (R(1.25)F group), 1.5 mg/ml ropivacaine (R(1.5) group) or 1.5 mg/ml ropivacaine with 0.2 mcg/kg/h of fentanyl (R(1.5)F group) for post-operative epidural analgesia. The epidural catheter was threaded caudally through the L4-5 interspace. The face, legs, activity, cry, consolability (FLACC) score was assessed at every hour and at FLACC score >4, an epidural bolus of 0.5 ml/kg of ropivacaine 1.5 mg/ml was given as the rescue analgesia. The incidence of side effects such as hypoxia, sedation, pruritus, nausea and/or vomiting was recorded.
Results: The need for rescue analgesia was higher in the R(1.25) group compared with that in the other three groups (all P<0.05). The incidence of side effects was higher in the R(1.5)F group compared with that in the R(1.25) and R(1.5) groups (both P=0.010).
Conclusion: The addition of 0.2 mcg/kg/h fentanyl to 1.5 mg/ml ropivacaine increased the incidence of side effects without improvement of analgesia in infants and children undergoing hypospadias repair. The use of plain 1.25 mg/ml ropivacaine increased the need for rescue analgesia and this could be compensated by addition of fentanyl. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19572930 |
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