Volume 11, Number 11, 621-624, DOI: 10.1007/BF00300716

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Continuous epidural morphine/butorphanol infusion following selective dorsal rhizotomy in children

C. David Lawhorn, Frederick A. Boop, Raeford E. Brown, Pamela D. Andelman, Michael L. Schmitz, Patti J. Kymer and Robert Shirey

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Abstract

The authors prospectively evaluated 15 patients who had undergone selective dorsal rhizotomy who were given a continuous morphine/butorphanol infusion, to determine whether variations in the postoperative pain control and side effects seen using a bolus technique could be reduced. Patients had an epidural catheter placed at the end of the operative procedure through which 50–60 mgrg/kg preservative-free morphine and 15–20 mgrg/kg butorphanol was administered. A continuous epidural infusion of 5 mgrg/kg h morphine and 1.2 mgrg/kg h butorphanol was then initiated. Postoperatively, mean pain scores were excellent. No patient required additional systemic analgesics during the 72-h investigational period. A low incidence of nausea, and no vomiting, pruritus, or respiratory depression was reported by the cohort. All patients maintained oxygen saturations above 95%. This indicates that the use of a continuous epidural infusion provides excellent pain control, decreases the occurrence of untoward side effects, and allows the early initiation of occupational and physical therapy postoperatively.

Key words  Butorphanol - Dorsal rhizotomy - Epidural - Morphine - Spasticity

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