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Patient-controlled regional analgesia is effective in children: a preliminary report

[L’analgésie régionale auto-contrôlée est efficace chez les enfants : une étude préliminaire]

Frédéric Duflo, MD^*, Youssef Qamouss, MD^*, Charlotte Rémond, MD^*, Agnès Pouyau, MD^*, Armand Heilporn, MD^*, Patricia Taylor, MD^*, Brigitte Paturel, MD^*, Sylvie Combet, MD^*, Emmanuel Boselli, MD^*, Franck Chotel, MD, Jérôme Bérard, MD PhD and Dominique Chassard, MD PhD^*

^* From the Departments of Anesthésie-Réanimation, and
Chirurgie Infantile Orthopédique, Hôpital Debrousse, Lyon, France.

Address correspondence to: Dr. Frédéric Duflo, Département d’Anesthésie-Réanimation, Hôpital Debrousse, 29, rue Sur Bouvier, 69322 Lyon Cedex 05, France. Phone: 33-4-72-41-31-72; Fax: 33-4-72-41-31-35; E-mail: frederic.duflo{at}chu-lyon.fr

Purpose: To report a preliminary analysis of prospectively recorded data in 27 children in whom patient-controlled regional analgesia (PCRA) was used for postoperative pain control following lower limb surgery.

Methods: Under general anesthesia, perineural catheters (popliteal and fascia iliaca compartment block) were inserted and infused with ropivacaine 0.2% (0.02 mL·kg^–1·hr^–1). Additional demand doses were left to the child’s discretion (0.1 mL·kg^–1and a 30-min lockout interval).

Results: The average total dose of ropivacaine administered was 4.9 ± 2 mg·kg^–1over 48 hr. Visual analogue scale and Children’s Hospital of Eastern Ontario Pain Scale scores were always inferior to 5/10 and 6/13, respectively. Motor block was observed in two children and two children needed rescue analgesia.

Conclusions: Our preliminary observations indicate that PCRA in children provides satisfactory postoperative pain relief following lower limb surgery.

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				F. Duflo, V. Sautou-Miranda, A. Pouyau, P. Taylor, S. Combet, F. Chotel, N. Bleyzac, and D. Chassard Efficacy and plasma levels of ropivacaine for children: controlled regional analgesia following lower limb surgery Br. J. Anaesth., August 1, 2006; 97(2): 250 - 254. [Abstract] [Full Text] [PDF]