engleski

Postoperative analgesia with intravenous fentanyl PCA vs epidural block after thoracoscopic pectus excavatum repair in children

Background : The aim of this prospective, randomized study was to compare the outcome - analgesia, sedation and respiratory function in children after thoracoscopic operations of pectus excavatum sec Nuss using two types of analgesia – by epidural catheter continious infusion of fentanyl plus bupivacaine or PCA (patient controlled analgesia) fentanyl iv. Methods: 28 patients ASA II scheduled for thoracoscopic operation of pectus excavatum were randomly assigned to two groups: the first group had received a thoracic epidural catheter before the induction of general anaesthesia, and the second group was planned for postoperative iv PCA. VAS and Ramsay sedation scores, arterial pressure, respiratory and pulse rate were measured postoperatively and blood gas analyses were performed. Results: Demographic data were equal between groups. There was no statistically significant difference found between postoperative pain and sedation scores, respiratory and cardiovascular function. PCO2 values were significantly higher in the PCA group 2, 6 and 12 hours postoperatively, but without other signs of respiratory depression. Conclusion: Fentanyl iv PCA is as effective as thoracic epidural analgesia in postoperative recovery in children after a Nuss operation. Being aware of the possible complications of epidural catheters’ thoracic placement in children, the use of fentanyl iv PCA is recommended.

analgesia; PCA; epidural; fentanyl; pectus excavatum

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