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Ketorolac or fentanyl continuous infusion for post‐operative analgesia in children undergoing ureteroneocystostomy
Author(s) -
JO Y. Y.,
HONG J. Y.,
CHOI E. K.,
KIL H. K.
Publication year - 2011
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2010.02354.x
Subject(s) - medicine , ketorolac , fentanyl , anesthesia , ropivacaine , analgesic , bolus (digestion) , surgery
Background: Children undergoing ureteroneocystostomy suffer from post‐operative pain due to the surgical incision and bladder spasm. A single‐shot caudal block is a common technique for paediatric analgesia, but a disadvantage is the limitation of a short duration in spite of the additives co‐administered. A few clinical trials have shown that ketorolac provides an effective post‐operative analgesia and reduces the bladder spasms after ureteral implantation in children. We compared the efficacy of a continuous infusion of ketorolac and fentanyl in post‐operative analgesia and bladder spasm in children who underwent ureteroneocystostomy. Methods: Fifty‐two children were allocated to the ketorolac group (Group K, n =26) and fentanyl group (Group F, n =26). After general anaesthesia, a caudal block was performed with 1.5 ml/kg of 0.15% ropivacaine. At the beginning of surgery, an infusion was started after the bolus injection of ketorolac 0.5 mg/kg or fentanyl 1 μg/kg. An infusion device was programmed to deliver ketorolac 83.3 μg/kg/h or fentanyl 0.17 μg/kg/h for 48 h. Results: Two of Group F and three of Group K were excluded from the study. Post‐operative pain scores were similar between the two groups. One of Group K (4%) and seven of Group F (30.4%) experienced bladder spasms. The rescue analgesic requirements were significantly less in Group K. Conclusions: A Continuous infusion of ketorolac provided effective analgesia after operation in children who underwent ureteroneocystostomy as well as a low dosage of fentanyl. Ketorolac was more effective in reducing the frequency of bladder spasms and rescue analgesic requirements.