Korean J Anesthesiol.  2005 Nov;49(5):624-629. 10.4097/kjae.2005.49.5.624.

Intravenous Patient-Controlled Analgesia Using Fentanyl after Nuss Procedure in Pediatric Patients Undergoing Pectus Excavatum Repair

• Ahn KR
• Chung JW
• Kwon JH
• Kang KS
• Lee JS
• Yoo SH
• Jung SH

• KMID: 1936816
• DOI: http://doi.org/10.4097/kjae.2005.49.5.624

Abstract

BACKGROUND: Nuss procedure used in pectus excavatum repair is preferred, because of its excellent effect from the cosmetic point of view and improved pulmonary function, but it cause severe pain due to thoracic expansion after the operation. This study was designed to evaluate effective fentanyl dose using an intravenous patient-controlled analgesia (IV-PCA) pump for pain control following pectus excavatum repair in pediatric patients.
METHODS
Sixty patients undergoing elective thoracic surgery were randomly assigned to received fentanyl 0.5microgram/kg/hr (Group I, n = 20), 0.7microgram/kg/hr (Group II, n = 20), and 1.0microgram/kg/hr (Group III, n = 20) via an IV-PCA pump (basal, 1 ml/h; bolus, 0.5 ml; lock out interval, 30 min) after operation. A blind observer evaluated each patient using the Children's Hospital of Eastern Ontario pain scale (CHEOPS) and the faces scale (FS). Incidences of side effects and pain control satisfaction were assessed at postoperative 48 hrs.
RESULTS
There were no significant differences in CHEOPS or FS score between the groups the postoperative 48 hrs period. CHEOPS and FS scores at 4 and 8 hrs in groups II and III were significantly lower than in group I (P<0.05), but all groups showed lower CHEOPS and FS scores during the first postoperative 48 hrs. Satisfaction of pain control assessment by mothers was significantly higher in groups II and III than in group I (P<0.05). CHEOPS and FS scores were highly correlated with each other (P<0.001).
CONCLUSIONS
We conclude that infusion of fentanyl at 0.5microgram/kg/hr using an IV-PCA pump is effective for pain control of 5 years of age or older after Nuss procedure.

Keyword

CHEOPS; fentanyl; FS; intravenous patient-controlled analgesia; pectus excavatum

MeSH Terms

Analgesia, Patient-Controlled*
Fentanyl*
Funnel Chest*
Humans
Incidence
Mothers
Ontario
Thoracic Surgery
Fentanyl