Vergleichende Analyse des peri- und postoperativen Verlaufs bei Kindern mit abdominalen Tumoren mit und ohne Periduralkatheter

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Dokumentart: PhDThesis
Date: 2014-06
Language: German
Faculty: 4 Medizinische Fakultät
Department: Medizinische Fakultät
Advisor: Warmann, S.W. (Prof. Dr.)
Day of Oral Examination: 2014-05-08
DDC Classifikation: 610 - Medicine and health
Keywords: Anästhesie
Other Keywords: Periduralanästhesie
abdominaler Tumor
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Vergleichende Analyse zum Schmerzmanagement mittels Periduralkatheter in der onkologischen Pädiatrie nach chirurgischen Interventionen bei Kindern mit abdominalen Tumoren.


Abstract PURPOSE: The purpose of this study was to assess the use of continuous epidural analgesia in pediatric patients undergoing major abdominal tumor surgery. METHODS: Children undergoing major abdominal tumor surgery at our institution between 2008 and 2012 (n=40) received continuous epidural analgesia via an epidural catheter. Surgical trauma scores, pain scores, and clinical data of the children were compared to a pair-matched historical control group operated on between 2002 and 2007 without epidural analgesia. RESULTS: Pain levels in the study group on day 1 and 3 after surgery were lower compared to the control group. The differences did, however, not reach statistical significance (p=0.15 and 0.09). Children in the study group received significantly fewer additional doses of piritramide or morphine (45% versus 82%, p<0.001). Despite significantly higher surgical trauma scores in the study group (p=0.018), there were no statistical differences regarding clinical parameters, such as mechanical ventilation time, time on intensive care unit, and total hospital stay. There were no catheter-related complications. CONCLUSIONS: Continuous epidural analgesia is beneficial for children undergoing complex abdominal tumor surgery with regard to pain levels, postoperative recovery, and general clinical course. Expertise of the managing team, a careful patient selection, and a continuous quality assessment are essential for success.

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