Continuous chloroprocaine infusion for thoracic and caudal epidurals as a postoperative analgesia modality in neonates, infants, and children

• DOI: 10.1111/pan.12807
• Publication Date: 2015-11-04T10:13:11Z
• Authors: Giorgio Veneziano; Peter Iliev; Jennifer Tripi; David Martin; Jennifer Aldrink; Tarun Bhalla; Joseph Tobias
• Keywords: Hydromorphone; Interquartile range; FLACC scale

Neonates and infants have decreased metabolic capacity for amide local anesthetics increased risk of anesthetic toxicity compared to the general population. Chloroprocaine is an ester that has extremely short plasma half-life in as well adults. Existing reports support safety efficacy continuous chloroprocaine epidural infusions neonates young during intraoperative period. Despite this, infusion may be under-utilized method postoperative analgesia this patient In particular, it improve pain control with incisions stretching many dermatomes or those hepatic impairment.We retrospectively reviewed our experience over 4 years neonates, infants, children a focus on management pain.Twenty-one pediatric patients received 2-chloroprocaine from January 2010 April 2014 thoracic, abdominal, limb procedures. The consisted 1.5% fentanyl. Tabulating morphine hydromorphone used rescue analgesia, median (interquartile range) opioid consumption (mg·kg(-1) ·day(-1) intravenous equivalents) first, second, third 24-h periods were 0.02 (0-0.48), 0.30 (0-0.44), 0.14 (0-0.29), respectively. Examining total fentanyl usage, (μg·kg(-1) ·day(-1)) 3.89 (0.41-7.24), 0 (0.00-4.06), (0.00-0.51), N-PASS score assessed every 6 h 72 postoperatively was 0, 1, 2, FLACC respectively.The results suggest offers efficacious alternative