CONTINUOUS EPIDURAL MORPHINE BUTORPHANOL INFUSION FOLLOWING SELECTIVEDORSAL RHIZOTOMY IN CHILDREN/

The authors prospectively evaluated 15 patients who had undergone sele ctive dorsal rhizotomy who were given a continuous morphine/butorphano l infusion, to determine whether variations in the postoperative pain control and side effects seen using a bolus technique could be reduced . Patients had an epidural catheter placed at the end of the operative procedure through which 50-60,mu g/kg preservative-free morphine and 15-20 mu g/kg butorphanol was administered. A continuous epidural infu sion of 5 mu g/kg h morphine and 1.2 mu g/kg h butorphanol was then in itiated. Postoperatively, mean pain scores were excellent. No patient required additional systemic analgesics during the 72-h investigationa l period. A low incidence of nausea, and no vomiting, pruritus, or res piratory depression was reported by the cohort. All patients maintaine d oxygen saturations above 95%. This indicates that the use of a conti nuous epidural infusion provides excellent pain control, decreases the occurrence of untoward side effects, and allows the early initiation of occupational and physical therapy postoperatively.