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Korean Journal of Anesthesiology 2002;42(4):472-477.
DOI: https://doi.org/10.4097/kjae.2002.42.4.472   
The Analgesic Effects of Caudal Morphine and Meperidine Containing Bupivacaine in Pediatric Open Heart Surgery.
Ji Yeon Sim, In Young Huh, Su Kyung Choi, In Cheol Choi
Department of Anesthesiology, College of Medicine, University of Ulsan, Seoul, Korea. jysim@amc.seoul.kr
In both infants and children, increased hormonal and metabolic responses to open heart surgery may be directly related to postoperative complications. Anesthestic management including regional anesthesia can substantially attenuate a perioperative stress response and targeted therapy may improve the outcome. In this study, our objectives were to quantify the extent of pain control, and to evaluate the safety and efficacy of caudal morphine or meperidine.
Seventy-five pediatric patients undergoing a open heart surgery were randomly assigned to three groups according to receiving morphine (group M, n = 25), or meperidine (group D, n = 25) caudally, and a control group (group C). Caudal morphine 30ng/kg with 0.15% bupivacaine 1 ml/kg or meperidine 2 mg/kg with 0.15% bupivacaine 1 ml/kg was injected after anesthetic induction. Pain score and side effects were evaluated immediate postoperatively, 12, 24, and 48 hr postoperatively in the intensive care unit and consciousness recovery and extubation time were checked.
Patients in the groups M and D had significantly lower pain scores than the group C. Recovery and extubation time were shorter in the groups M and D. Incidence of nausea and vomiting was significantly higher in the group M than in the groups D and C.
Caudal morphine and meperidine reduced postoperative pain and facilitated extubation.
Key Words: Bupivacaine; caudal epidural; meperidine; morphine; pediatric open heart surgery


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