BACKGROUND: Patient-controlled analgesia has been used with increasing frequency to provide postoperative pain relief for children. We compared the effects of continuous plus bolus patient-controlled fentanyl analgesia with those of bolus patient-controlled fentanyl analgesia.
METHODS: One hundred and thirty four children (aged 3-8 yr) undergoing orthopedic surgeries received one of two analgesic regimens of fentanyl based patient-controlled analgesia (PCA); bolus infusion of 0.4µg/kg with a 15 minute lock-out interval (group B) or continuous (0.2µg/kg/hr) and bolus infusion (0.2µg/kg) with a 15 minute lock-out interval (group C). We compared the two groups in terms of degree of analgesia, sedation and nausea.
RESULTS: Analgesic effects were better in group B at 1 and 2 hours after surgery. The incidence of sedation in group C was greater than in group B at 1 and 2 hours after surgery, and the groups were similar in terms of the incidences of nausea.
CONCLUSIONS: We concluded that bolus infusion of fentanyl in children did not increase the incidence of side effects and that it was associated with a better analgesic effect than continuous and bolus fentanyl infusion.