Intravenous Patient-controlled Analgesia for Postoperative Pain Management in Patients with Cerebral Palsy

Purpose: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. Materials and Methods: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. Results: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. Conclusion: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.

[1]  J. Yoo,et al.  The Effect of Arm Position on the Repaired Capsulolabrum after Arthroscopic Bankart Repair: Magnetic Resonance Imaging Study , 2005 .

[2]  S. Suk,et al.  Pedicle Screw Fixation in Pediatric Spinal Deformities , 2005 .

[3]  B. Atilla,et al.  Meperidine-induced seizure after revision hip arthroplasty. , 2005, The Journal of arthroplasty.

[4]  R. Barkin,et al.  Meperidine: A Critical Review , 2002, American journal of therapeutics.

[5]  J. Lötsch,et al.  Drug Interactions with Patient-Controlled Analgesia , 2002, Clinical Pharmacokinetics.

[6]  R. Dreisbach,et al.  Analgesics, antipyretics, and anti-inflammatory agents , 2001 .

[7]  A. Scheinberg,et al.  Continuous intrathecal baclofen infusion for children with cerebral palsy: A pilot study , 2001, Journal of paediatrics and child health.

[8]  L. Krach,et al.  Intrathecal Baclofen for Management of Spastic Cerebral Palsy: Multicenter Trial , 2000, Journal of child neurology.

[9]  M. Ehrlich,et al.  The role of ketorolac in decreasing length of stay and narcotic complications in the postoperative pediatric orthopaedic patient. , 1999, Journal of pediatric orthopedics.

[10]  B. Shaw,et al.  Comparison of morphine patient-controlled analgesia with and without ketorolac for postoperative analgesia in pediatric orthopedic surgery. , 1999, American journal of orthopedics.

[11]  H. Kokki,et al.  Ketorolac, diclofenac and ketoprofen are equally efficacious for pain relief after total hip replacement surgery. , 1998, British journal of anaesthesia.

[12]  B. Joyce,et al.  Reliability and validity of the Faces and Word Descriptor Scales to measure procedural pain. , 1996, Journal of pediatric nursing.

[13]  M. Hadley,et al.  Prospective study on the use of bolus intrathecal baclofen for spastic hypertonia due to acquired brain injury. , 1996, Archives of physical medicine and rehabilitation.

[14]  Steinmetz Pr Indices of pain intensity: construct validity among preschoolers. , 1995 .

[15]  T. Vetter,et al.  Intravenous ketorolac as an adjuvant to pediatric patient-controlled analgesia with morphine. , 1994, Journal of clinical anesthesia.

[16]  J. Janosky,et al.  Continuous intrathecal baclofen infusion for spasticity of cerebral origin. , 1993, JAMA.

[17]  J. Robertson Pediatric pain assessment: validation of a multidimensional tool. , 1993, Pediatric nursing.

[18]  D. Bourke,et al.  Assessment of Ketorolac as an Adjuvant to Fentanyl Patient‐controlled Epidural Analgesia after Radical Retropubic Prostatectomy , 1993, Anesthesiology.

[19]  Gureno Ma,et al.  Patient controlled analgesia for the young pediatric patient. , 1991 .

[20]  L. Aarons,et al.  Investigations into the potential effects of multiple dose ketorolac on the pharmacokinetics and pharmacodynamics of racemic warfarin. , 1990, British journal of clinical pharmacology.

[21]  B. Rodgers,et al.  Patient-controlled analgesia in pediatric surgery. , 1988, Journal of pediatric surgery.

[22]  F. Sarnquist,et al.  Ketorolac tromethamine absorption, distribution, metabolism, excretion, and pharmacokinetics in animals and humans. , 1987, Drug metabolism and disposition: the biological fate of chemicals.

[23]  P. Mcgrath,et al.  Multi-dimensional pain assessment in children , 1984, PAIN.

[24]  J. Heykants,et al.  Plasma protein binding and distribution of fentanyl, sufentanil, alfentanil and lofentanil in blood. , 1982, Archives internationales de pharmacodynamie et de therapie.