術後鎮痛をおもな目的とした小児に対する持続硬膜外ブロック

概要

論文の詳細を見る
Over the last 5 years, 245 children, ranging in age from 3Y7M to 18Y, were scheduled for continuous epidural block for alleviating perioperative pain, and placement of an epidural catheter into the epidural space was successful in 237 cases. Complications occurred in two cases. One was attributable to an overdose of local anesthetic during surgery, resulting in a convulsuion in the recovery room. The other case was an accidental intravascular cannulation into the perivertebral venous plexus, which was clearly demonstrated by contrast medium injected through the catheter. Thirty-nine patients under-going surgery for vesico-urethral reflux were allocated randomly to four groups depending on the concentration of local anesthetic used and whether or not caudal block was added, in order to investigate which was more effec-tive for postoperative pain relief. However, none was no-ticeably superior. It is concluded that although continuous epidural block is certainly effective, we should not rely solely on pharmaceutical support, but should also use the mothers' psychological assurance to achieve satisfactory postoperative pain relief in children.
日本小児外科学会の論文
1990-08-20