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Morphine with or without a local anaesthetic for postoperative intrathecal pain treatment after selective dorsal rhizotomy in children
Author(s) -
Hesselgard K.,
Strömblad L.G.,
Reinstrup P.
Publication year - 2001
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2001.00606.x
Subject(s) - medicine , rhizotomy , morphine , anesthesia , bupivacaine , spasticity , surgery , dorsum , anatomy
Selective dorsal rhizotomy is a surgical procedure with a selective division of posterior spinal nerve rootlets to treat spasticity in children. The extensive surgical procedure with multilevel laminectomies and the nerve root manipulation result in intense pain postoperatively. Two intrathecal (IT) regimes of pain treatment were compared in these children, concerning their pain relief and possible side‐effects. In a prospective study, 12 children (3–6 years of age) with six in each group, received either intermittent IT morphine (5 μg·kg −1 four times a day) or continuous infusion of a mixture of bupivacaine (40 μg·kg −1 ·h −1 ) and morphine (0.6 μg·kg −1 ·h −1 ). Pain score was lower in the bupivacaine/morphine group (0.2 ± 1.1) compared to intermittent morphine (2 ± 2.4) on a scale from 0 to 6 ( P ≤ 0.0001). Bupivacaine/morphine resulted in a lower, but not significant, difference in pruritus and lower muscle spasm. Haemodynamic and ventilatory parameters did not differ between the groups. Intrathecal continuous infusion of bupivacaine and morphine was superior to intermittent morphine in the treatment of pain after selective dorsal rhizotomy operations.