Comparing Three Different Doses of Caudal Morphine for Analgesia after Salter Innominate Osteotomy
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2016, Vol 16, Issue 6
Abstract
Background: Single dose caudal block application is preferred among children since it is a safe and easy method. Caudal morphine has an important advantage with its long half-life. However, caudal morphine application has some side effects such as nausea-vomiting, urinary retention, pruritus, sedation and respiratory stiffness and many of those are dose-dependent. The aim of this study was to determine the minimum morphine doses that will provide adequate analgesia and by this way to diminish the life threatening side effects such as respiratory depression as well as comfort-threatening side effects such as nausea-vomiting. Methods: This double blind, randomized, prospective study, was performed in Gaziantep University among 60 pediatric patients aged between 1-9 years, who were planned to have Salter operation for congenital hip dislocation, with ASA classification of I-II. Premedication was not applied in any of the cases. Patients were sub-grouped randomly and for 15, 20 or 25 μg.kg-1 caudal morphine administration: G15, G20 and G25. Caudal injections were performed under general anesthesia just before the operations. Having total volumes of 0.75 ml.kg-1, caudal injections were performed with 15, 20 or 25 μg.kg-1 morphine together with 0.25% bupivacaine according to the groups. The first time of analgesic requirement was recorded. Results: The number of cases required analgesia in first 24 hours was determined as 4 (20%), 3 (15%) and 2 (10%) in Group 15, Group 20 and Group 25, respectively. There was not statistically significant difference between groups (P>0.05). In none of the patients, the pain level was as high as causing restlessness (score 2). With single dose Paracetamol, pain cured in all of these patients. Postoperative nausea and vomiting in first 24 hours was reported in 1 (5%), 2 (10%) and 8 (40%) cases in 15, 20 and 25 µg.kg-1 groups, respectively. Although the difference between Groups 15 and 20 was not statistically significant (p=0.548), the number of patients with nausea and vomiting in Group 25 was statistically significantly higher than that of Group 15 and Group 20 (p=0.009 and p=0.025, respectively). In first 24 hours in postoperative period, respiratory depression was not observed in any of the cases. Conclusions: We determined that decreasing the caudal morphine dose to 15 µg.kg-1 in Salter osteotomy does not decrease analgesia in 24 hours but minimizes nausea-vomiting incidence.
Authors and Affiliations
Nurgül Işikay, Mehmet Cesur, Ertuğrul Kılıc, Mehmet Murat Çelik
Keywords
Related Articles
- EP ID EP341492
- DOI 10.9734/BJMMR/2016/25760
- Views 50
- Downloads 0
A Rare Case of Cockayne Syndrome
Background: Cockayne syndrome is a rare autosomal recessive congenital disorder characterized by growth failure, impaired development of the nervous system, abnormal sensitivity to sunlight (photosensitivity), and premat...
Obesity and Hypertension among Christian Religious Subgroups: Pentecostal vs. Orthodox
Aims: The aim of this study was to determine the impact of religious practices and diet doctrines on obesity and hypertension among Pentecostal and orthodox Christians in the Tamale metropolis. Study Design: This study...
Case Report: Suprachoroidal Catheterization “ab-interno” for Treatment of Open Angle Glaucoma: “BABLY TECHNIQUE”
A cataractous and open angle glaucomatous right eye of a 60 year old man was surgically treated in a different way. First, phacoemulsification with posterior chamber intraocular lens was done, then, under gonioscopy, I t...
Biochemical Assessment of Malnutrition in Sudanese Patients with Chronic Renal Failure on Hemodialysis Maintenance Therapy
Background: Malnutrition in Chronic Kidney Disease Patients on Hemodialysis remains one of the major causes of morbidity and mortality characterized by changes in circulating levels of plasma albumin, pre-albumin and tra...
Psychosocial Assessment of Voice Problems among Saudi Imams
Background and Objective: Imams, who lead prayers for Muslims, are considered among professional voice users. They have high vocal demand during their prayer times, Khutbah, and educating sessions for Muslims. The aim of...