The effect of caudal morphine analgesia on extubation time in paediatric cardiac surgery

Abstract

The aim of this study was to evaluate the effect of caudal morphine analgesia (CMA) on extubation time in a group of paediatric cardiac surgery patients which, depending on the complexity of the surgical procedure and the haemodynamic stability, usually could be early extubated. We included 116 paediatric cardiac surgery patients between 5 month and 10 years of age, randomly allocated to two groups of 58 each: Group I CMA (100 μg/kg morphine in saline 0.5 ml/kg) and Group II no CMA. The premedication and induction was similar in both groups. For anaesthetic maintenance both groups received isoflurane (0.5-1%) and fentanyl. The fentanyl dose was variable, as required to block autonomic reactions during surgical intervention. The amount of intraoperative fentanyl and extubation time was recorded. The mean dose of intraoperative i.v. fentanyl was significantly lower in Group I, 2.45±1.65 μg/kg/h, versus Group II, 8.9±3.46 μg/kg/h (p<0,001). Also the time to extubation was significantly shorter in Group I patients, 2.56±2.69 h, compared with Group II patients, 5.65±3.48 h (p<0.01).

Key words: anaesthesia: paediatric cardiac surgery, anaesthetic techniques: caudal analgesia, narcotic perispinal: morphine, extubation: time of extubation

Jurnalul Român de Anestezie Terapie intensivă 2003 Vol.10 Nr.2, 131-134

Efectul analgeziei caudale cu morfină asupra timpului de extubare în chirurgia cardiacă pediatrică