The effect of caudal levobupivacaine and morphine combination in pediatric lower extremity orthopedic surgery

Amaç: Bu çalışmada pediyatrik ortopedide, alt ekstremite girişimlerinde kaudal levobupivakaine eklenen IV veya kaudal morfin kombinasyonunun peroperatif ve postoperatif etkilerini retrospektif olarak değerlendirmeyi amaçladık. Gereç ve Yöntem: Alt ekstremite osteotomisi geçiren genel anestezi sonrası kaudal analjezi uygulanan 2-12 yaş arası 40 hastanın anestezi takip formları incelendi. Kaudal analjezi için 0.5 ml.kg %0.25 levobupivakaine 20µg.kg morfin eklenen hastalar(Grup I) ile yine kaudal olarak verilen 0.5 ml.kg % 0.25 levobupivakine IV 0.1 mg.kg morfin eklenen hastaların (Grup II) peroperatif hemodinamik ve postoperatif analjezi etkileri karşılaştırıldı. Bulgular: Guruplar arasında yaş, boy, ağırlık, ameliyat süreleri açısından anlamlı bir farklılık bulunmamıştır. Peroperatif ve postoperatif hemodinamik değişiklikler açısından gruplar arasında fark saptanmadı. İlk analjezik gereksinim süresi Grup I için 644± 160 dk, Grup II için 542± 98 dk bulundu. (p

Anahtar Kelimeler:

Geriyedönük çalışma, Analjezi, Çocuk, Çocuk, okul öncesi, Morfin, Hemodinamikler

Pediyatrik alt ekstremite ortopedik cerrahisinde kaudal levobupivakain ve morfin kombinasyonunun etkileri

Introduction: In this study, we evaluated the peroperative and postoperative effects of caudal levobupivacaine and IV or caudal morphine retrospectively. Materials and Methods: We retrospectively evaluated the records of healthy 40 children aged between 2-12 years, who had osteotomy for lower extremity under general anesthesia and caudal blockade. The solution injected was 0.5ml.kg1 volume of 0.25% levobupivacaine including 20µg.kg-1morphine (Group I) or only 0.25% levobupivacaine with IV morphine added at a dose of 0.1 mg.kg-1 (Group II). We compared the groups in terms of peroperative hemodynamic changes and postoperative analgesia. Results: No significant differences were found in terms of age, height, weight and duration of surgery. We did not observed any peroperative or postoperative hemodynamic changes needing intervention for any patients (p>0.05). The mean time to the first analgesic need was 644±160 min. for Group I and 542.3±98 min. for Group II (p<0.05). None of the patients had side effects such as motor blockade, nausea, vomiting and pruritus. Conclusion: Among pediatric patients who underwent lower extremity surgery, morphine added caudally to levobupivacaine provided a longer duration of analgesia without leading to clinically significant hemodynamic changes and side effects when compared to IV doses of morphine added to levobupivacaine.

Keywords:

Retrospective Studies, Analgesia, Child, Child, Preschool, Morphine, Hemodynamics,

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