Abstract
Patient-Controlled-Epidural-Analgesia, a scheduled postoperative pain relief method with epidural block using 0.125% of bupivacaine, was provided for 10 patients whose age ranged from 6 to 17 year old. PCEA was commenced on the first postoperative day. The effective injection was designated as "good". On the other hand, if the injection could not be carried out within the lock out time, the printer recorded the dummy pushes as "bad". The PCEA setting were as follows; the injection time was 10 min., the amount of local anesthetics was determined between 5〜8 ml depending upon the extent of surgical field, age and the stature of patients, and the lock out time was set to 90 min. More patients pushed more "bad" buttons than "good" ones in their postoperative course, that is, overall patients were not satisfied with the setting. The number of the "bad" pushes was examined every 10 min. after the former injection. The "bad" appeared within 1 min after the effective injection and the first peak in numbers of the "bad" was found 20〜30 min. and the second peak was noticed between 80〜90 min. Those results brought us a speculation that the most effective analgesic effect by epidural block with 0.125% bupivacaine with or without 1μg/ml of fentanyl can be obtained within 10〜20 min. after injection and the analgesic effect can be maintained for 50〜70 min. However, taking into consideration that patients still requested more analgesics even just after the former injection and during the effective period, we could estimate that a large population of pedialric patients expected rapid onset, long lasting and more stable analgesic state than the fluctuating analgesic level such as intermittent epidural blocks.
