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Morphine with or without a local anaesthetic for postoperative intrathecal pain treatment after selective dorsal rhizotomy in children

Hesselgard, Karin LU ; Strömblad, Lars-Göran LU and Reinstrup, Peter LU (2001) In Paediatric Anaesthesia 11(1). p.75-79
Abstract
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 microg x kg(-1) four times a day) or continuous infusion of a mixture of bupivacaine (40 microg x kg(-1) x h(-1)) and morphine (0.6 microg x kg(-1) x h(-1)). Pain score was lower in the bupivacaine/morphine... (More)
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 microg x kg(-1) four times a day) or continuous infusion of a mixture of bupivacaine (40 microg x kg(-1) x h(-1)) and morphine (0.6 microg x kg(-1) x 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 less than or = 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. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Paediatric Anaesthesia
volume
11
issue
1
pages
75 - 79
publisher
Wiley-Blackwell
external identifiers
  • pmid:11123736
  • scopus:0035181886
ISSN
1460-9592
DOI
10.1046/j.1460-9592.2001.00606.x
language
English
LU publication?
yes
id
12561cfc-ab61-49f0-95a3-4ed86bf29dab (old id 1121484)
date added to LUP
2016-04-01 15:37:09
date last changed
2022-01-28 06:16:29
@article{12561cfc-ab61-49f0-95a3-4ed86bf29dab,
  abstract     = {{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 microg x kg(-1) four times a day) or continuous infusion of a mixture of bupivacaine (40 microg x kg(-1) x h(-1)) and morphine (0.6 microg x kg(-1) x 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 less than or = 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.}},
  author       = {{Hesselgard, Karin and Strömblad, Lars-Göran and Reinstrup, Peter}},
  issn         = {{1460-9592}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{75--79}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Paediatric Anaesthesia}},
  title        = {{Morphine with or without a local anaesthetic for postoperative intrathecal pain treatment after selective dorsal rhizotomy in children}},
  url          = {{http://dx.doi.org/10.1046/j.1460-9592.2001.00606.x}},
  doi          = {{10.1046/j.1460-9592.2001.00606.x}},
  volume       = {{11}},
  year         = {{2001}},
}