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Makale1
Postoperative analgesia after paediatric orchidopexy: evaluation of a bupivacaine-morphine mixture.
Author : Wolf AR; Hughes D; Wade A; Mather SJ; Prys Roberts C
Adres: Sir Humphry Davy Department of Anaesthesia, University of Bristol, Bristol Royal Hospital for Sick Children.
Kaynak : Br J Anaesth, 1990 Apr, 64:4, 430-5Özet :The value of combining morphine with bupivacaine for caudal analgesia was investigated. Thirty children, undergoing orchidopexy, received a caudal block of 0.125% bupivacaine with or without morphine 0.05 mg kg-1. Analgesia, side-effects, ventilatory freq uency and oxygen saturation (SaO2) were recorded after operation. None of the 15 patients receiving the bupivacaine-morphine mixture required post-operative opioids, whereas eight of 15 pa tients receiving bupivacaine alone needed additional opioid analgesia. The incidence of side effects after surgery was similar for the two groups and there was no detectable difference in ventilatory frequency or SaO2.
Makale 2
A comparison of postoperative analgesia provided by wound infiltration or caudal analgesia. Yazar : Schindler M; Swann M; Crawford M
Adres : Department of Anesthesia, Prince of Wales Hospital, Sydney, N.S.W., Australia. \par Kaynak : Anaesth Intensive Care, 1991 Feb, 19:1, 46-9Özet : A prospective randomised study was performed to compare postoperative analgesia produced by caudal block with that of local wound infiltration in 54 children following unilateral inguinal herniotomy. There was no statistically signif icant difference in the analgesia produced by these two methods. The requirement for additional postoperative analgesia and the incidence of side-effects was similar in the two groups. \par }}
Makale 3
Title : Combined morphine-bupivacaine caudals for reconstructive penile surgery in children: systemic absorption of morphine and postoperative analgesia.
Yazar : Wolf AR; Hughes D; Hobbs AJ; Prys Roberts C
Adres: Sir Humphry Davy Department of Anaesthesia, University of Bristol, Bristol Royal Hospital for Sick Children, England.
Kaynak : Anaesth Intensive Care, 1991 Feb, 19:1, 17-21Özet : We wished to determine if the addition of a small dose of morphine (0.05 mg.kg-1) to a caudal solution of 0.25% bupivacaine could extend the duration of analgesia after major reconstructive penile surgery and also to measure the systemic absorption of mor phine after caudal injection. Thirty children undergoing reconstructive penile surgery received a caudal injection of 0.25% bupivacaine 0.75 ml.kg-1 with or without morphine 0.05 mg.kg-1. All patients awoke pain-free, but eight of the fifteen patients receiving bupivacaine alone required supplementary injections of opioid postoperatively, whereas none of the patients receiving the bupivacaine-morphine mixture required additional o pioids. The incidence of side-effects was similar for the two groups. Morphine was absorbed rapidly after caudal injection to reach a peak plasma level of 21.2 (+/- 4.8) ng.ml-1 at ten minutes and then fell to 10.1 (+/- 3.8) ng.ml-1 at one hour and 4.1 (+ /- 2.6) ng.ml-1 at three hours. These levels are low compared with plasma levels associated with systemic analgesia. We conclude that the extended duration of analgesia from morphine 0.05 mg/kg given caudally is due at least in part to specific spinal analg esia.
Makale 4
Continuous paravertebral block for postthoracotomy analgesia in children.
Yazar : Eng J; Sabanathan S
Adres: Department of Thoracic Surgery, Bradford Royal Infirmary, England. \par Source : J Pediatr Surg, 1992 May, 27:5, 556-7Özet : Abstract \par Si x children with a mean age of 10.6 years (range, 7 to 16 years) underwent thoracotomy for pulmonary and esophageal procedures. Postoperatively, continuous paravertebral block using an infusion of bupivacaine via an extrapleural catheter was used. Excellen t analgesia was attained in all patients, with no requirement for opiates or other analgesic drugs. There were no pulmonary complications and no complications related to the continuous extrapleural infusion. We conclude that continuous paravertebral block is an effective and safe method for ++post-thoracotomy pain relief in children. \par }}
Makale 5
Postoperative analgesia in children who have genito-urinary surgery. A comparison between caudal buprenorphine and bupivacaine
Yazar : Girotra S; Kumar S; Rajendran KM
Adres: Department of Anaesthesiology, Maulana Azad Medical College, New Delhi, India. \par Kaynak : Anaesthesia, 1990 May, 45:5, 406-8Özet : A study conducted on 40 children, aged 1-11 years, who had genito-urinary surgery compared t he quality and duration of analgesia after caudal blocks in two groups of patients. Group 1 (n = 20) received caudal bupivacaine 0.25% and group 2 (n = 20) caudal buprenorphine 4 micrograms/kg; each received 0.5 ml/kg body weight. Patients were operated o n under general anaesthesia. Postoperative behaviour and severity of pain were measured on a 3-point scale. The results indicate that caudal buprenorphine provides excellent postoperative analgesia in children comparable to caudal bupivacaine in the early postoperative period. Buprenorphine proved better in the late postoperative period. Analgesia lasted from 20 hours to more than 24 hours after caudal buprenorphine with fewer side effects.
Makale 6
Presurgical analgesia in children subjected to hypospadias repair
Yazar : Atallah MM; Saied MM; Yahya R; Ghaly AM
Adres:Faculty of Medicine, University of Mansoura, Mansoura-Egypt.
Kaynak :Br J Anaesth, 1993 Sep, 71:3, 418-21Özet : We have examined the use of different pre-surgical analgesic techniques in 30 children aged 2-10 yr undergoing repair of hypospadias. They were allocated randomly, in a double-blind, placebo-controlled study, to receive one of three analgesic techniques (n = 10): lumbar extradural analgesia using 0.5% bupivacaine 1 mg kg-1 plus morphine 50 micrograms kg-1; morphine 100 micrograms kg-1 i.m.; or subpubic block using 0.5% bupivacaine 0.5 mg kg-1 for each side. Analgesics were given after induction of anaesthesia and before the start of surgery. Children given extradural analge si a had more stable haemodynamic variables and smaller catecholamine concentrations and needed less anaesthetic supplementation, with no analgesic requirement in the postoperative period. Nausea or vomiting were not reported in children given subpubic block .
Makale 7
Analgesia following inguinal herniotomy or orchidopexy in children: a comparison of caudal and regional blockade.
Yazar :Scott AD; Phillips A; White JB; Stow PJ
Kaynak : J R Coll Surg Edinb, 1989 Jun, 34:3, 143-5Özet : The effectiveness o f postoperative analgesia was compared in 44 children undergoing inguinal surgery, 19 of whom received caudal analgesia (1 ml 0.2% bupivacaine/kg) and 25 ilioinguinal block (0.25 ml 0.5% bupivacaine/kg). The requirement for supplementary analgesia (intram uscular morphine) was less in the caudal group, although this did not reach statistical significance in the number studied. Ilioinguinal and caudal blockade both provide useful postoperative analgesia for children following ilioinguinal surgery.