Thoraxchirurgie bei Kindern - Postoperative Schmerztherapie

Christina Jaki; Franz-Josef Kretz

doi:10.1055/s-2006-955863

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 2006; 41(10): 666-668
DOI: 10.1055/s-2006-955863

Fachwissen: Topthema: Thoraxchirurgie bei Kindern

Thoraxchirurgie bei Kindern - Postoperative Schmerztherapie

Thoracic surgery in children - Pain control after surgeryChristina Jaki, Franz-Josef Kretz

Abstract

Zusammenfassung

In der postoperativen Phase nach thoraxchirurgischen Eingriffen bei Kindern kann es zu erheblichen Schmerzen kommen. Das Repertoire der analgetischen Therapie besteht aus Basistherapie mit Nichtopioidanalgetika wie Paracetamol oder Ibuprofen, sowie der bedarfsorientierten Therapie mit Opioiden unter intensivmedizinischer Überwachung. Darüber hinaus kommen auch Regionalanästhesiemethoden als ein wichtiger Mosaikstein einer effektiven Schmerztherapie nach thoraxchirurgischen Eingriffen im Kindesalter zum Einsatz.

Summary

In the postoperative phase after thoracic surgery in children patients can suffer considerable pain. The repertoire of analgesic treatments consist of basic treatment with non-opioid analgesics such as paracetamol or ibuprofen, as well as need-determined treatments with opioids given under intensive care monitoring. In addition, local and regional anaesthetic methods are an important part of the big picture of effective pain control after thoracic surgery in children.

Schlüsselwörter:

Thoraxchirurgie bei Kindern - Schmerztherapie nach thoraxchirurgischen Eingriffen bei Kindern - postoperative Schmerztherapie bei Kindern - Regionalanästhesie nach thoraxchirurgischen Eingriffen

Key words:

Thoracic surgery in children - pain control after thoracic surgery in children - pain control after surgery in children - regional anaesthetic methods after thoracic surgery in children

Full Text

References

Literatur

1 Bremerich DH, Neidhart G., Roth B., Kessler P., Behne M.. Postoperative paintherapy in pediatrics. Results of a representative survey in Germany. Anaesthesist. 2001; 2 102-12
2 Lemburg P. Fühlen Neugeborene Schmerzen?. In Kretz, F.-J., Schier, F. Das Kind im Spannungsfeld zwischen Anästhesie und Chirurgie. Heidelberg: Springer 1991
3 Anand KJ., Sippell WG., Aynsley-Green.. A Randomised trial of Fentanyl Anaesthesia in preterm babie undergoing surgery: effects on the stress response. Lancet. 1987; 1 62-6
4 Taddio A., Katz J., Ilerisch AL, Koren G.. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1997; 349 599-603
5 Anand KJ. Pain, Plasticity and premature birth: a prescription for permanent suffering?. Nat med. 2000; 6 971-73
6 Nuss D., Kelly RE, Croitora DP, Katz ME. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J. Pediatric. Surs. 1998; 33 545-52
7 Büttner W., Breitkopf L., Miele B., Früke W. Initial results of the reliability and validity of the German language scale for the quantitative measurement of postoperative pain in young children. Anaesthesist. 1990; 39 583-602
8 Anderson BL, Lin Yc, Sussman H., Benitz LNE. Paracetamol pharmacokinetics in the premature neonate: the problem of limited data. Pediatric Anesthesia. 1998; 8 442-4
9 Rasch DK, Webster DE, Pollard TG, Gurkowski MA. Lumbar and thoracic epidural analgesia via the caudal approach for postoperative pain relief in infants and children. Can J Anaesth. 1990; 37 359-62
10 Tsui BC, Wagner A, Cave D, Kearney R. Thoracic and lumbar epidural analgesia via the caudal approach using eletrical stimulation guidance in pediatric patient: a review of 289 patients. Anesthesiology 2004;3:683-9. Golianu B, Hammer GB. Pain management for pediatric ghoracic surgery. Curr Opin Anaesthesiol. 2005; 18 13-21
11 Chawathe MS, Jones RM, Gildersleve CD, Harrison SK, Morris SJ, Eickmann C. Detection of epidural catheters with ultrasound in children. Paediatr Anaesth. 2003; 13 681-4
12 Willschke H, Marhofer P, Bosenberg A, Johnston S, Wanzel O, Sitzwohl C, Kettner S, Kapral S. Epidural catheter placement in children: comparing a novel approach using ultrasound guidance and a standard loss-of-resistance technique. Br J Anaesth. 2006; 97 200-7
13 Bubeck J, Boos K, Krause H, Thies KC. Subcutaneous tunnelling of caudal catheters reduces the rate of bacterial colonization to that of lumbar epidural catheters. Anesth Analg. 2004; 99 689-93
14 Kost-Byerly S, Tobin JR, Greenberg RS, Billett C, Zahurak M, Yaster M. Bacterial colonization and infection rate of continuous epidural catheters in children. Anesth Analg. 1998; 86 712-6
15 Akbas M, Akbas H, Yegin A, Sahin N, Titiz TA. Comparison of the effects of clonidine and ketamine added to ropivacaine on stress hormone levels and the duration of caudal analgesia. Paediatr Anaesth. 2005; 15 580-5
16 Marhofer P, Koinig H. The choice of drugs for caudal anaesthesia in children. An overview. Anaesthesist. 2003; 52 55-67
17 De Negri P, Ivani G, Visconti C, De Vivo P. How to prolong postoperative analgesia after caudal anaesthesia with ropivacaine in children: S-ketamine versus clonidine. Paediatr Anaesth. 2001; 11 679-83
18 B Grubb DJ, Aldridge LA, Doyle E. Comparison of the effects of adrenalin, clonidine and ketamine on the duration of caudal analgesia produced by bupivacaine in children. Br J Anaesth. 1995; 75 698-701
19 Semple D, Findlow D, Aldridge LM, Doyle E. The optimal dose of ketamine for caudal epidural blockade in children. Anaesthesia. 1996; 51 1170-2
20 Panjabi N, Prakash S, Gupta P, Gogia AR. Efficacy of three doses of ketamine with bupivacaine for caudal analgesia in pediatric inguinal herniotomy. Reg Anesth Pain Med. 2004; 29 28-31