J Korean Med Sci.  2008 Feb;23(1):122-125. 10.3346/jkms.2008.23.1.122.

Parent-Controlled Analgesia in Children Undergoing Cleft Palate Repair

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. ktmin501@yumc.yonsei.ac.kr
  • 2Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Goyang, Korea.
  • 3Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.

Abstract

The aims of this study were to find an optimal basal infusion dose of fentanyl for parent-controlled analgesia (PrCA) in children undergoing cleft palate repair and the degree of parents' satisfaction with PrCA. Thirty consecutive children between 6 months and 2 yr of age were enrolled. At the end of surgery, a PrCA device with a basal infusion rate of 2 mL/hr and bolus of 0.5 mL with lockout time of 15 min was applied. Parents were educated in patient-controlled analgesia (PCA) devices, the Wong Baker face pain scoring system, and monitoring of adverse effects of fentanyl. Fentanyl was infused 0.3 microgram/kg/hr at first, and we obtained a predetermined fentanyl regimen by the response of the previous patient to a larger or smaller dose of fentanyl (0.1 microgram/kg/hr as the step size), using an up-and-down method. ED50 and ED95 by probit analysis were 0.63 microgram/kg/hr (95% confidence limits, 0.55-0.73 microgram/kg/hr) and 0.83 microgram/kg/hr (95% confidence limits, 0.73-1.47 microgram/kg/hr), respectively. Eighty seven percent of the parents were satisfied with participating in the PrCA modality. PrCA using fentanyl with a basal infusion rate of 0.63 microgram/kg/hr can be applied effectively for postoperative pain management in children undergoing cleft palate repair with a high level of parents' satisfaction.

Keyword

Analgesia, Parent-Controlled; Cleft Palate; Fentanyl; Pain, Postoperative

MeSH Terms

*Analgesia, Patient-Controlled
Child, Preschool
Cleft Palate/*surgery
Female
Fentanyl/therapeutic use
Humans
Infant
Male
*Parents
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