Comparison of Low-dose Epidural With Intravenous Narcotic Versus Intravenous Narcotic Alone
| Status: | Terminated |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 4 - 16 |
| Updated: | 4/21/2016 |
| Start Date: | January 2006 |
| End Date: | June 2006 |
Comparison of Epidural Bupivacaine-Clonidine With Intravenous Morphine Versus Intravenous Morphine Alone for Post-Operative Pain Relief in Pediatric Patients Undergoing Lower Extremity or Pelvic Osteotomy.
The purpose of the study is to determine if a low-dose epidural drug mixture without
narcotic will result in lower parenteral narcotic usage, and improved side-effect profile
for post-operative pain in the pediatric population undergoing lower extremity or pelvic
osteotomy.
narcotic will result in lower parenteral narcotic usage, and improved side-effect profile
for post-operative pain in the pediatric population undergoing lower extremity or pelvic
osteotomy.
Post-operative pain in patients undergoing osteotomy can be severe. Current methods of
treatment involve parenteral narcotics and regional anesthesia. Several studies have looked
at the efficacy of regional anesthesia with various combinations of local anesthetic and
additives in different populations. However, to our knowledge there have been none that
directly compare bupivacaine/clonidine epidural with supplemental narcotics to parenteral
narcotics alone. Many studies substantiate the efficacy of bupivacaine and clonidine as
effective drugs for epidural analgesia (1,2,3). Parenteral narcotic alone is associated with
the possibility of significant side effects, overdose, and inadequate analgesia. Epidural
analgesia has been shown to reduce postoperative pain scores more than parenteral narcotics
(4). We believe that this study is important since the protocol allows additional parenteral
narcotic in the epidural group if needed, and also allows for narcotic dosing prior to
discontinuation of the epidural to compensate for rebound pain. Further, the prolongation of
pain control shown with epidural clonidine may be beneficial during the transition (5,6).
treatment involve parenteral narcotics and regional anesthesia. Several studies have looked
at the efficacy of regional anesthesia with various combinations of local anesthetic and
additives in different populations. However, to our knowledge there have been none that
directly compare bupivacaine/clonidine epidural with supplemental narcotics to parenteral
narcotics alone. Many studies substantiate the efficacy of bupivacaine and clonidine as
effective drugs for epidural analgesia (1,2,3). Parenteral narcotic alone is associated with
the possibility of significant side effects, overdose, and inadequate analgesia. Epidural
analgesia has been shown to reduce postoperative pain scores more than parenteral narcotics
(4). We believe that this study is important since the protocol allows additional parenteral
narcotic in the epidural group if needed, and also allows for narcotic dosing prior to
discontinuation of the epidural to compensate for rebound pain. Further, the prolongation of
pain control shown with epidural clonidine may be beneficial during the transition (5,6).
Inclusion Criteria:
- Age 4-16
- English speaking
- Elective lower extremity osteotomy
- Expected length of stay greater than 24 hours
Exclusion Criteria:
- History of previous spine surgery
- Current infection overlying catheter insertion site
- Coagulopathy
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