Lumbar Epidural Analgesia for Operative and Postoperative pain relief in Children

Abstract

This study was done in Assuit university hospital at orthopedic department between 2000-200 I to assess the effect of epidural anesthesia on postoperative pain intensity, degree of pain relief and side effects as well as the haemodynamic variables ( heart rate and mean arterial blood pressure ) in children undergoing orthopedic surgery . Thirty six child aged from 3-12 years old admitted to orthopedic department to have operations on the pelvis or the lower limbs . The children were premedicated with intramuscular injection of atropine sulfate 0.02 mglkg and diazepam 0.2 mg/kg. Following •the establishment of an intravenous line and monitoring of the heart rate and non-invasive blood pressure and according to the age of the child,•general anesthesia was induced using either halothane and nitrous oxide I oxygen or intravenous thiopentone ( 2-4 mg/kg ) followed by a non depolarizing muscle relaxant after which the trachea was intubated . All children received a standard infusion of 5% Dextrose 7-I 0 mllkg during the first one hour of anesthesia None of the patients needed blood or vasoactive dmgs . None received opioids either a premedication or through the epidural catheter .

Under complete aseptic conditions epidural penetration attempted at L "-; space with the child in the lateral decubitus position . Identification of the epidural space was done by using loss of resistance to air technique .