UI - 000167

AU - Tobias JD

AU - Oakes L

AU - Austin BA

TI - Pediatric analgesia with epidural fentanyl citrate administered by nursing staff

AB - Even though epidural analgesia is effective and has advantages over conventional postoperative

analgesia, it is also labor intensive, requiring 24-hour supervision by an anesthesiologist. In an effort to

decrease the manpower requirements, some hospitals allow the nursing staff to administer epidural narcotics

to adult patients. In children, however, this practice has been limited. We retrospectively reviewed our

experience over 12 months with this procedure. Epidural catheters (caudal, lumbar, or thoracic) were placed

in 43 pediatric patients for acute and chronic pain management. All patients received a continuous epidural

infusion of bupivacaine hydrochloride with fentanyl citrate. Eleven (26%) of the 43 patients required

supplemental analgesia and were given 45 doses of epidural fentanyl. Adequate analgesia was achieved in all

patients. No intravascular or intrathecal injections were noted, nor did any inadvertent epidural injections of

medications occur. No patient had respiratory depression (respiratory rate less than 10% for age). We

believe epidural administration of fentanyl by a carefully educated nursing staff is safe and effective in

children.

SO - Southern Medical Journal 1992;85:384-38