Local anesthetic wound infusion versus standard analgesia in paediatric post-operative pain control

摘要: Local anesthetic wound infusion has shown promising results in adults. Its use children is limited to some centers and there are only a few prospective trials this group of patients. Sub-fascial continuous local anaesthetic (CLAWI) (0.2 % Bupivacaine) plus intravenous paracetamol rescue morphine was compared to: (a) Epidural bupivacaine (EPI) for patients undergoing laparotomy. (b) Intravenous (standard post-operative analgesia—SAPA) Lanz incision laparotomy complicated appendicitis. ‘InfiltralLong’, PANJUNK® catheters were placed sub-fascially after peritoneal closure infusion. Pain scores recorded regularly by the same blinded pain specialist. The primary outcomes control total morphine. secondary time full feeds, mobilization requirement urinary catheter complications. Sixty (18 laparotomy-CLAWI, 17 laparotomy-EPI 12 appendectomy-CLAWI, 13 appendectomy-SAPA) analyzed. average score 2.5 (1–4) CLAWI groups, 3.0 (1–5) EPI 3.5 (2–5) SAPA group. Morphine requirements markedly less CLAWI. groups required longer took mobilize (average 4 days 2 days CLAWI). There no or complications Continuous subfascial reliable, safe effective paediatric with considerably reduced opiate requirements.