الفهرس | Only 14 pages are availabe for public view |
Abstract Background and Objective: Numerous researches have been done to study the paediatric side effects of epidural morphine. The effect of age on the incidence of these side effects was unclear. N20 is considered as a contributing factor of PONY but this is still controversial in both adults and children. This study was designed to show the age spectrum of side effects of epidural morphine and effect of N20 on PONY in paediatric patients. Methods: Computer-generated Raridomized Controlled trial in Urology & Nephrology Center, Mane-iura University, Mansoura, Egypt. (December 2000 to August 2001). 200 children aged 2-12 years were allocated to be generally anaesthetized by Isoflurance, 02 with or without N20. Morphine and bupivacaine were administered in the lumbar epidural space to study the effect of age, N20, type of surgery and duration of anaesthesia on the incidence of epidural morphine side effects including pruritus, PONV, urine retention, respiratory depression and conscious level of children. Results : There were stable haemodynamics and good analgesia. Pruritus, PONY and urine retention had occured in the same incidence reported before (68.5%, 43.5% and 13%) respectively. There were no severe side effects like respiratory depression or disturbance of the child’s conscious level. Pruritus and urine retention were decreasing in their incidence with age. But, PONY was increasing with the age to reach its maximum incidence at 8 years old, then, decreased to achieve the adult incidence at 11-12 years old. N20 did not increase the incidence of PONY. Excessive manipulation of the bowel and traction on the peritonium during abdominal surgery produced a higher incidence of PONY when compared with other procedures. like hypospadias repair and orchiopexy. Anaesthesia for more than two hours associated with more higher incidence of PONY, pruritus and urine retention. |