Very Low Dose Caudal Morphine for Postoperative Pain Management
| Status: | Completed |
|---|---|
| Conditions: | Post-Surgical Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | Any - 10 |
| Updated: | 11/23/2017 |
| Start Date: | January 2010 |
| End Date: | December 11, 2012 |
The Use of Very Low Dose Caudal Morphine for Postoperative Pain Management in Out Patients
This is a chart review. The aim of this study is to investigate the effectiveness and side
effects of very low dose morphine administered caudally to children that went to surgical
procedures that used caudal anesthesia. The study compares caudal block with Bupivacaine (1
ml kg_1 of bupivacaine 0.25% and saline 0.02 ml kg_10) with very low dose morphine (a mix of
1 ml kg_-1 of ropivacaine 0.2% and preservative-free morphine: 10 µg kg-1).
effects of very low dose morphine administered caudally to children that went to surgical
procedures that used caudal anesthesia. The study compares caudal block with Bupivacaine (1
ml kg_1 of bupivacaine 0.25% and saline 0.02 ml kg_10) with very low dose morphine (a mix of
1 ml kg_-1 of ropivacaine 0.2% and preservative-free morphine: 10 µg kg-1).
Caudal anesthesia is the most common technique of epidural anesthesia in children. Caudal
anesthesia is recommended for most surgical procedures of the lower part of the body,
including herniorrhaphies; operations on the urinary tract, anus, and rectum; and orthopedic
procedures on the pelvic girdle and lower extremities. Many anesthetic agents have been used
for caudal anesthesia in pediatric patients, with lidocaine and Bupivacaine being most
common. The major problems associated with this technique are the limited duration of
analgesia and unwanted motor blockade.
Addition of medications that prolong analgesia after a single shot caudal block has been
investigated. Several authors have mentioned a special interest in using an opioid like
morphine in caudal block for postoperative analgesia. When low dose morphine is used, the
side effects are lower than when higher dose of morphine are used. A larger and definitive
study is needed to compare very low dose morphine via caudal administration and caudal block
without Opioid with regard to duration of analgesia and frequency of side effects. We plan to
conduct a chart review in our center on pediatric patients that went to urological,
orthopedic, and general surgery procedures for which caudal block were given and compare the
effectiveness and side effects of very low dose morphine and caudal block without Opioid.
anesthesia is recommended for most surgical procedures of the lower part of the body,
including herniorrhaphies; operations on the urinary tract, anus, and rectum; and orthopedic
procedures on the pelvic girdle and lower extremities. Many anesthetic agents have been used
for caudal anesthesia in pediatric patients, with lidocaine and Bupivacaine being most
common. The major problems associated with this technique are the limited duration of
analgesia and unwanted motor blockade.
Addition of medications that prolong analgesia after a single shot caudal block has been
investigated. Several authors have mentioned a special interest in using an opioid like
morphine in caudal block for postoperative analgesia. When low dose morphine is used, the
side effects are lower than when higher dose of morphine are used. A larger and definitive
study is needed to compare very low dose morphine via caudal administration and caudal block
without Opioid with regard to duration of analgesia and frequency of side effects. We plan to
conduct a chart review in our center on pediatric patients that went to urological,
orthopedic, and general surgery procedures for which caudal block were given and compare the
effectiveness and side effects of very low dose morphine and caudal block without Opioid.
Inclusion Criteria:
- The subject did have elective Urological procedures such us circumcision, orchidopexy
and inguinal hernia repair, orthopedic and general surgery procedures for which caudal
block are usually administered for pain management.
Exclusion Criteria:
- Subjects with non elective or emergency surgery (must have the surgery no matter
what).
- Subjects with surgical procedures that are not planned to be conducted with the use of
general anesthesia. Subjects that are not allowed to receive the anesthesia agents
indicated per protocol and general anesthesia.
- American Society of Anesthesiologists, Physical Status classification greater than 2
(uncontrolled systemic disease or more than one systemic disease).
- Patients with a history of chronic pain conditions.
- Infection around the sacral hiatus.
- Coagulopathy.
- Anatomic abnormalities.
- Patient with mentally retardation.
- Patient with history of attention deficit and/or behavioral problems.
We found this trial at
1
site
Oklahoma City, Oklahoma 73104
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