Comparison of continuous epidural and intravenous analgesia for postoperative pain control in children

Objective:To compare the effect of combined general-epidural anesthesia and postoperative analgesia and fentanyl intravenously injected.Methods:91 pediatric patients undergoing lower extremities surgery randomly divided into epidural lidocaine group (n=61) and IV fentanyl group (n=30). During the operation, end-tidal enflurane concentration was controlled to maintain the blood pressure and heart rate within 10% of preoperative value. At the postoperative period, Parent Visual Analog Scale (PVAS), Objective Pain Score (OPS) and the incidence of nausea/vomiting were checked immediately, 6 hours and 24 hours after the patient's arriving at general ward.Results:Enflurane was significantly lower in epidural lidocaine group than that in IV fentanyl group (P0.05).Compare to IV fentanyl group, epidural lidocaine goup had significantly lower OPS at 6 hours after arrival. Epidural lidocaine group had significantly lower PVAS immediately 6 and 24 h after arrival. There was no significant difference in the incidence of postoperative nausea and vomiting between two groups.Conclusion:A combined general-epidural anesthesia could significantly decrease end-tidal enflurane concentration. Continuous patient-controlled epidural analgesia reduces postoperative pain scores significantly more than continuous patient-controlled IV fentanyl analgesia without any serious complications in pediatric lower extremity surgery.