Abstract

Background: We compared the effects of epidural levobupivacaine and levobupivacaine plus morphine administration on postoperative analgesia in children undergoing major abdominal surgery.
Methods: After the approval by our Faculty Ethic Committee and informed consent of parents were taken, 47 children, aged between 1-14 year, undergoing major abdominal surgery were included. Following the anesthesia induction, an epidural catheter (22-24 G) was inserted by using Tuohy needle (19-20 G). Patients were randomly divided iiinto two groups. Epidural block was performed with levobupivacaine (0.125%) plus morphine (30μg/kg) in group I patients, and sole levobupivacaine (0.25%) in group II patients.
Peroperative sevoflurane concentration, systolic and diastolic blood pressure and heart rate were recorded. Pain and sedation scores were recorded postoperatively. Side effects and the number of patients who required rescue analgesics were noted.
Results: Sevoflurane concentrations were lower in group I patients than in group II patients at 10th and 30th
minutes intraoperatively. In the first postoperative day, the number of the patients who required rescue analgesic was 7 in group I and 18 in group II (p=0.003). The duration of postoperative analgesia was longer in group I patients than group II patients (p=0.002). Pain and sedation scores were lower in group I patients than group II patients (por respiratory depression.

Conclusions: We concluded that, epidural levobupivacaine plus morphine combination reduced intraoperative anesthetic concentration, supplied longer postoperative analgesia and required less rescue postoperative analgesic than sole levobupivacine, but it caused higher sedation.