Lumbar epidural morphine for postoperative analgesia in children undergoing Nuss procedure]

We examined the effects of lumbar epidural morphine for postoperative analgesia in children after the Nuss procedure for funnel chest.An epidural catheter was inserted from the L 3-4 interspace preoperatively (epidural group). Epidural morphine 30 microg x kg(-1) was given at the beginning of the operation. Postoperatively, epidural morphine 3 microg x kg(-1) x hr(-1) was infused. The frequency of demand for postoperative analgesia was retrospectively compared with that of children who had not received epidural morphine (control group).On the 0th postoperative day, the epidural group required fewer analgesics than the control group (0.50+/-0.30 vs. 2.50+/-1.00 x day(-1)). However, after the 1st postoperative day, the demand for analgesia did not differ between the two groups.Epidural morphine 30 microg x kg(-1) given at the beginning of operation provided effective analgesia on the 0th postoperative day after the Nuss procedure. However, epidural infusion of morphine 3 microg x kg(-1) x hr(-1) was not effective after the 1st postoperative day. Further study is needed to determine the lumbar epidural infusion dose of morphine adequate for use after the Nuss procedure.