Ketorolac or fentanyl continuous infusion for post-operative analgesia in children undergoing ureteroneocystostomy
Article first published online: 17 NOV 2010
© 2010 The Authors. Journal compilation © 2010 The Acta Anaesthesiologica Scandinavica Foundation
Acta Anaesthesiologica Scandinavica
Volume 55, Issue 1, pages 54–59, January 2011
How to Cite
JO, Y. Y., HONG, J. Y., CHOI, E. K. and KIL, H. K. (2011), Ketorolac or fentanyl continuous infusion for post-operative analgesia in children undergoing ureteroneocystostomy. Acta Anaesthesiologica Scandinavica, 55: 54–59. doi: 10.1111/j.1399-6576.2010.02354.x
- Issue published online: 3 DEC 2010
- Article first published online: 17 NOV 2010
- Accepted for publication 13 October 2010
Background: Children undergoing ureteroneocystostomy suffer from post-operative pain due to the surgical incision and bladder spasm. A single-shot caudal block is a common technique for paediatric analgesia, but a disadvantage is the limitation of a short duration in spite of the additives co-administered. A few clinical trials have shown that ketorolac provides an effective post-operative analgesia and reduces the bladder spasms after ureteral implantation in children. We compared the efficacy of a continuous infusion of ketorolac and fentanyl in post-operative analgesia and bladder spasm in children who underwent ureteroneocystostomy.
Methods: Fifty-two children were allocated to the ketorolac group (Group K, n=26) and fentanyl group (Group F, n=26). After general anaesthesia, a caudal block was performed with 1.5 ml/kg of 0.15% ropivacaine. At the beginning of surgery, an infusion was started after the bolus injection of ketorolac 0.5 mg/kg or fentanyl 1 μg/kg. An infusion device was programmed to deliver ketorolac 83.3 μg/kg/h or fentanyl 0.17 μg/kg/h for 48 h.
Results: Two of Group F and three of Group K were excluded from the study. Post-operative pain scores were similar between the two groups. One of Group K (4%) and seven of Group F (30.4%) experienced bladder spasms. The rescue analgesic requirements were significantly less in Group K.
Conclusions: A Continuous infusion of ketorolac provided effective analgesia after operation in children who underwent ureteroneocystostomy as well as a low dosage of fentanyl. Ketorolac was more effective in reducing the frequency of bladder spasms and rescue analgesic requirements.