321 Taenzer AH, Clark C, Taenzer AH et al.Efficacy of postoperative epidural analgesia<strong>in</strong> adolescent scoliosis surgery: a meta-analysis.Paediatr Anaesth 2010; 20: 135–143.322 Lavelle ED, Lavelle WF, <strong>Good</strong>w<strong>in</strong> R et al.Epidural analgesia for postoperative pa<strong>in</strong>control after adolescent sp<strong>in</strong>al fusion procedureswhich violated the epidural space. JSp<strong>in</strong>al Disord Tech 2010; 23: 347–350.323 <strong>Good</strong>arzi M. The advantages of <strong>in</strong>trathecalopioids for sp<strong>in</strong>al fusion <strong>in</strong> children. PaediatrAnaesth 1998; 8: 131–134.324 Gall O, Aub<strong>in</strong>eau J, Berniere J et al. Analgesiceffect of low-dose <strong>in</strong>trathecal morph<strong>in</strong>eafter sp<strong>in</strong>al fusion <strong>in</strong> children. Anesthesiology2001; 94: 447–452.325 Eschertzhuber S, Hohlrieder M, Keller C etal. Comparison of high- <strong>and</strong> low-dose <strong>in</strong>trathecalmorph<strong>in</strong>e for sp<strong>in</strong>al fusion <strong>in</strong> children.Br J Anaesth 2008; 100: 538–543.326 Tripi PA, Poe-Kochert C, Potzman J et al.Intrathecal morph<strong>in</strong>e for postoperative analgesia<strong>in</strong> patients with idiopathic scoliosisundergo<strong>in</strong>g posterior sp<strong>in</strong>al fusion. Sp<strong>in</strong>e(Phila Pa 1976) 2008; 33: 2248–2251.327 Tobias JD, Ga<strong>in</strong>es RW, Lowry KJ et al. Adual epidural catheter technique to provideanalgesia follow<strong>in</strong>g posterior sp<strong>in</strong>al fusionfor scoliosis <strong>in</strong> children <strong>and</strong> adolescents.Paediatr Anaesth 2001; 11: 199–203.328 Ekatodramis G, M<strong>in</strong> K, Cathre<strong>in</strong> P et al.Use of a double epidural catheter provideseffective postoperative analgesia after sp<strong>in</strong>edeformity surgery. Can J Anaesth 2002; 49:173–177.329 Blumenthal S, M<strong>in</strong> K, Nadig M et al. Doubleepidural catheter with ropivaca<strong>in</strong>e versus<strong>in</strong>travenous morph<strong>in</strong>e: a comparison forpostoperative analgesia after scoliosis correctionsurgery. Anesthesiology 2005; 102:175–180.330 Cassady JJ, Lederhaas G, Cancel D et al. Ar<strong>and</strong>omized comparison of the effects ofcont<strong>in</strong>uous thoracic epidural analgesia <strong>and</strong><strong>in</strong>travenous patient-controlled analgesiaafter posterior sp<strong>in</strong>al fusion <strong>in</strong> adolescents.Reg Anesth Pa<strong>in</strong> Med 2000; 25: 246–253.331 O’Hara JFJr, Cyw<strong>in</strong>ski JB, Tetzlaff JE et al.The effect of epidural vs <strong>in</strong>travenous analgesiafor posterior sp<strong>in</strong>al fusion surgery. PaediatrAnaesth 2004; 14: 1009–1015.332 Arms D, Smith J, Osteyee J et al. <strong>Postoperative</strong>epidural analgesia for pediatric sp<strong>in</strong>esurgery. Orthopedics 1998; 21: 539–544.333 Sucato DJ, Duey-Holtz A, Elerson E et al.<strong>Postoperative</strong> analgesia follow<strong>in</strong>g surgicalcorrection for adolescent idiopathic scoliosis:a comparison of cont<strong>in</strong>uous epiduralanalgesia <strong>and</strong> patient-controlled analgesia.Sp<strong>in</strong>e 2005; 30: 211–217.334 Poe-Kochert C, Tripi PA, Potzman J et al.Cont<strong>in</strong>uous <strong>in</strong>travenous morph<strong>in</strong>e <strong>in</strong>fusionfor postoperative analgesia follow<strong>in</strong>g posteriorsp<strong>in</strong>al fusion for idiopathic scoliosis.Sp<strong>in</strong>e 2010; 35: 754–757.335 <strong>Good</strong>arzi M, Shier NH, Grogan DP. Effectof <strong>in</strong>trathecal opioids on somatosensoryevokedpotentials dur<strong>in</strong>g sp<strong>in</strong>al fusion <strong>in</strong>children. Sp<strong>in</strong>e 1996; 21: 1565–1568.336 Shaw B, Watson T, Merzel D et al. Thesafety of cont<strong>in</strong>uous epidural <strong>in</strong>fusion forpostoperative analgesia <strong>in</strong> pediatric sp<strong>in</strong>esurgery. J Pediatr Orthop 1996; 16: 374–377.337 Turner A, Lee J, Mitchell R et al. The efficacyof surgically placed epidural cathetersfor analgesia after posterior sp<strong>in</strong>al surgery.Anaesthesia 2000; 55: 370–373.338 Lowry KJ, Tobias J, Kittle D et al. <strong>Postoperative</strong>pa<strong>in</strong> control us<strong>in</strong>g epidural cathetersafter anterior sp<strong>in</strong>al fusion for adolescentscoliosis. Sp<strong>in</strong>e 2001; 26: 1290–1293.339 Saudan S, Habre W, Ceroni D et al. Safety<strong>and</strong> efficacy of patient controlled epiduralanalgesia follow<strong>in</strong>g pediatric sp<strong>in</strong>al surgery.Paediatr Anaesth 2008; 18: 132–139.340 Vitale MG, Choe JC, Hwang MW et al.Use of ketorolac trometham<strong>in</strong>e <strong>in</strong> childrenundergo<strong>in</strong>g scoliosis surgery. an analysis ofcomplications. Sp<strong>in</strong>e J 2003; 3: 55–62.341 Rusy LM, Ha<strong>in</strong>sworth KR, Nelson TJ et al.Gabapent<strong>in</strong> use <strong>in</strong> pediatric sp<strong>in</strong>al fusionpatients: a r<strong>and</strong>omized, double-bl<strong>in</strong>d, controlledtrial. Anesth Analg 2010; 110: 1393–1398.342 Engelhardt T, Zaarour C, Naser B et al. Intraoperativelow-dose ketam<strong>in</strong>e does notprevent a remifentanil-<strong>in</strong>duced <strong>in</strong>crease <strong>in</strong>morph<strong>in</strong>e requirement after pediatric scoliosissurgery. Anesth Analg 2008; 107: 1170–1175.343 Rub<strong>in</strong> K, Sullivan D, Sadhasivam S. Areperipheral <strong>and</strong> neuraxial blocks with ultrasoundguidance more effective <strong>and</strong> safe <strong>in</strong>children?Paediatr Anaesth 2009; 19: 92–96.344 Prabhu K, Wig J, Grewal S. Bilateral <strong>in</strong>fraorbitalnerve block is superior to peri-<strong>in</strong>cisional<strong>in</strong>filtration for analgesia after repairof cleft lip. Sc<strong>and</strong> J Plast Reconstr SurgH<strong>and</strong> Surg 1999; 33: 83–87.345 Eipe N, Choudhrie A, Pillai AD et al.Regional anesthesia for cleft lip repair: aprelim<strong>in</strong>ary study. Cleft Palate Craniofac J2006; 43: 138–141.346 Takmaz SA, Uysal HY, Uysal A et al.Bilateral extraoral, <strong>in</strong>fraorbital nerve blockfor postoperative pa<strong>in</strong> relief after cleft liprepair <strong>in</strong> pediatric patients: a r<strong>and</strong>omized,double-bl<strong>in</strong>d controlled study. Ann PlastSurg 2009; 63: 59–62.347 Simion C, Corcoran J, Iyer A et al. <strong>Postoperative</strong>pa<strong>in</strong> control for primary cleft liprepair <strong>in</strong> <strong>in</strong>fants: is there an advantage <strong>in</strong>perform<strong>in</strong>g peripheral nerve blocks?Paediatr Anaesth 2008; 18: 1060–1065.348 Rajamani A, Kamat V, Rajavel VP et al. Acomparison of bilateral <strong>in</strong>fraorbital nerveblock with <strong>in</strong>travenous fentanyl for analgesiafollow<strong>in</strong>g cleft lip repair <strong>in</strong> children. PaediatrAnaesth 2007; 17: 133–139.349 Jonnavithula N, Durga P, Kulkarni DK etal. Bilateral <strong>in</strong>tra-oral, <strong>in</strong>fra-orbital nerveblock for postoperative analgesia follow<strong>in</strong>gcleft lip repair <strong>in</strong> paediatric patients: comparisonof bupivaca<strong>in</strong>e vs bupivaca<strong>in</strong>e-pethid<strong>in</strong>ecomb<strong>in</strong>ation. Anaesthesia 2007; 62:581–585.350 Mane RS, Sanikop CS, Dhulkhed VK et al.Comparison of bupivaca<strong>in</strong>e alone <strong>and</strong> <strong>in</strong>comb<strong>in</strong>ation with fentanyl or pethid<strong>in</strong>e forbilateral <strong>in</strong>fraorbital nerve block for postoperativeanalgesia <strong>in</strong> paediatric patients forcleft lip repair: a prospective r<strong>and</strong>omizeddouble bl<strong>in</strong>d study. J Anaesthesiol Cl<strong>in</strong>Pharmacol 2011; 27: 23–26.351 J<strong>in</strong>dal P, Khurana G, Dvivedi S et al. Intra<strong>and</strong> postoperative outcome of add<strong>in</strong>g clonid<strong>in</strong>eto bupivaca<strong>in</strong>e <strong>in</strong> <strong>in</strong>fraorbital nerveblock for young children undergo<strong>in</strong>g cleftlip surgery. Saudi J Anaesth 2011; 5: 289–294.352 Coban YK, Senoglu N, Oksuz H. Effects ofpreoperative local ropivaca<strong>in</strong>e <strong>in</strong>filtration onpostoperative pa<strong>in</strong> scores <strong>in</strong> <strong>in</strong>fants <strong>and</strong>small children undergo<strong>in</strong>g elective cleft palaterepair. J Craniofac Surg 2008; 19: 1221–1224.353 Obayah GM, Refaie A, Aboushanab O etal. Addition of dexmedetomid<strong>in</strong>e to bupivaca<strong>in</strong>efor greater palat<strong>in</strong>e nerve block prolongspostoperative analgesia after cleftpalate repair. Eur J Anaesthesiol 2010; 27:280–284.354 Mesnil M, Dadure C, Captier G et al. Anew approach for peri-operative analgesiaof cleft palate repair <strong>in</strong> <strong>in</strong>fants: the bilateralsuprazygomatic maxillary nerve block. PaediatrAnaesth 2010; 20: 343–349.355 Sylaidis P, O’Neill T. Diclofenac analgesiafollow<strong>in</strong>g cleft palate surgery. Cleft PalateCraniofac J 1998; 35: 544–545.356 Dawson KH, Egbert MA, Myall RW. Pa<strong>in</strong>follow<strong>in</strong>g iliac crest bone graft<strong>in</strong>g of alveolarclefts. J Craniomaxillofac Surg 1996; 24:151–154.357 Sbitany H, Koltz PF, Waldman J et al.Cont<strong>in</strong>uous bupivaca<strong>in</strong>e <strong>in</strong>fusion <strong>in</strong> iliacbone graft donor sites to m<strong>in</strong>imize pa<strong>in</strong> <strong>and</strong>hospitalization. Cleft Palate Craniofac J2010; 47: 293–296.358 Dashow JE, Lewis CW, Hopper RA et al.Bupivaca<strong>in</strong>e adm<strong>in</strong>istration <strong>and</strong> postoperativepa<strong>in</strong> follow<strong>in</strong>g anterior iliac crest bonegraft for alveolar cleft repair. Cleft PalateCraniofac J 2009; 46: 173–178.359 Cregg N, Conway F, Casey W. Analgesiaafter otoplasty: regional nerve blockade vslocal anaesthetic <strong>in</strong>filtration of the ear. CanJ Anaesth 1996; 43: 141–147.64 ª 2012 Blackwell Publish<strong>in</strong>g Ltd, Pediatric Anesthesia, 22 (Suppl. 1), 1–79
360 Shayevitz JR, Merkel S, O’Kelly SW et al.Lumbar epidural morph<strong>in</strong>e <strong>in</strong>fusions forchildren undergo<strong>in</strong>g cardiac surgery. J CardiothoracVasc Anesth 1996; 10: 217–224.361 Hammer GB, Ngo K, Macario A. A retrospectiveexam<strong>in</strong>ation of regional plus generalanesthesia <strong>in</strong> children undergo<strong>in</strong>g openheart surgery. Anesth Analg 2000; 90: 1020–1024.362 Peterson K, DeCampli W, Pike N et al.A report of two hundred twenty cases ofregional anesthesia <strong>in</strong> pediatric cardiacsurgery. Anesth Analg 2000; 90: 1014–1019.363 F<strong>in</strong>kel J, Boltz M, Conran A. The effect ofbaricity of <strong>in</strong>trathecal morph<strong>in</strong>e <strong>in</strong> childrenreceiv<strong>in</strong>g tetraca<strong>in</strong>e sp<strong>in</strong>al anaesthesia forcardiac surgery: a prelim<strong>in</strong>ary report. PaediatrAnaesth 2002; 12: 327–331.364 Pirat A, Akpek E, Arslan G. Intrathecalversus IV fentanyl <strong>in</strong> pediatric cardiac anesthesia.Anesth Analg 2002; 95: 1207–1214,table of contents.365 Suom<strong>in</strong>en P, Ragg P, McK<strong>in</strong>ley D et al.Intrathecal morph<strong>in</strong>e provides effective <strong>and</strong>safe analgesia <strong>in</strong> children after cardiac surgery.Acta Anaesthesiol Sc<strong>and</strong> 2004; 48:875–882.366 Hammer GB, Ramamoorthy C, Cao H etal. <strong>Postoperative</strong> analgesia after sp<strong>in</strong>alblockade <strong>in</strong> <strong>in</strong>fants <strong>and</strong> children undergo<strong>in</strong>gcardiac surgery. Anesth Analg 2005; 100:1283–1288,table of contents.367 Leyvi G, Taylor DG, Reith E et al. Caudalanesthesia <strong>in</strong> pediatric cardiac surgery: doesit affect outcome? J Cardiothorac VascAnesth 2005; 19: 734–738.368 Thammasitboon S, Rosen DA, Lutfi R etal. An <strong>in</strong>stitutional experience with epiduralanalgesia <strong>in</strong> children <strong>and</strong> young adultsundergo<strong>in</strong>g cardiac surgery. Paediatr Anaesth2010; 20: 720–726.369 Chu YC, L<strong>in</strong> SM, Hsieh YC et al. Intraoperativeadm<strong>in</strong>istration of tramadol for postoperativenurse-controlled analgesia resulted<strong>in</strong> earlier awaken<strong>in</strong>g <strong>and</strong> less sedation thanmorph<strong>in</strong>e <strong>in</strong> children after cardiac surgery.Anesth Analg 2006; 102: 1668–1673.370 Rosen DA, Hawk<strong>in</strong>berry DW2nd, RosenKR et al. An epidural hematoma <strong>in</strong> an adolescentpatient after cardiac surgery. AnesthAnalg 2004; 98: 966–969,table of contents.371 Gupta A, Daggett C, Drant S et al. Prospectiver<strong>and</strong>omized trial of ketorolac aftercongenital heart surgery. J CardiothoracVasc Anesth 2004; 18: 454–457.372 Birm<strong>in</strong>gham P, Wheeler M, Suresh S et al.Patient-controlled epidural analgesia <strong>in</strong> children:can they do it? Anesth Analg 2003; 96:686–691.373 L<strong>in</strong> Y, Sentivany-Coll<strong>in</strong>s S, Peterson K etal. Outcomes after s<strong>in</strong>gle <strong>in</strong>jection caudalepidural versus cont<strong>in</strong>uous <strong>in</strong>fusion epiduralvia caudal approach for postoperative analgesia<strong>in</strong> <strong>in</strong>fants <strong>and</strong> children undergo<strong>in</strong>gpatent ductus arteriosus ligation. PaediatrAnaesth 1999; 9: 139–143.374 Bozkurt P, Kaya G, Yeker Y et al. Effectivenessof morph<strong>in</strong>e via thoracic epiduralvs <strong>in</strong>travenous <strong>in</strong>fusion on postthoracotomypa<strong>in</strong> <strong>and</strong> stress response <strong>in</strong> children. PaediatrAnaesth 2004; 14: 748–754.375 Ioscovich A, Brisk<strong>in</strong> A, Deeb M et al. Oneshot sp<strong>in</strong>al morph<strong>in</strong>e <strong>in</strong>jection for postthoracotomypa<strong>in</strong> control <strong>in</strong> children [4]. PaediatrAnaesth 2004; 14: 971–972.376 Karmakar M, Booker P, Franks R et al.Cont<strong>in</strong>uous extrapleural paravertebral <strong>in</strong>fusionof bupivaca<strong>in</strong>e for post-thoracotomyanalgesia <strong>in</strong> young <strong>in</strong>fants. Br J Anaesth1996; 76: 811–815.377 Cheung S, Booker P, Franks R et al. Serumconcentrations of bupivaca<strong>in</strong>e dur<strong>in</strong>g prolongedcont<strong>in</strong>uous paravertebral <strong>in</strong>fusion <strong>in</strong>young <strong>in</strong>fants. Br J Anaesth 1997; 79: 9–13.378 Downs C, Cooper M. Cont<strong>in</strong>uous extrapleural<strong>in</strong>tercostal nerve block for post thoracotomyanalgesia <strong>in</strong> children. AnaesthIntensive Care 1997; 25: 390–397.379 Karmakar MK, Booker PD, Franks R.Bilateral cont<strong>in</strong>uous paravertebral blockused for postoperative analgesia <strong>in</strong> an <strong>in</strong>fanthav<strong>in</strong>g bilateral thoracotomy. Paediatr Anaesth1997; 7: 469–471.380 Shah R, Sabanathan S, Richardson J et al.Cont<strong>in</strong>uous paravertebral block for postthoracotomy analgesia <strong>in</strong> children. J CardiovascSurg (Tor<strong>in</strong>o) 1997; 38: 543–546.381 Karmakar M, Critchley L. Cont<strong>in</strong>uous extrapleural<strong>in</strong>tercostal nerve block for postthoracotomy analgesia <strong>in</strong> children. AnaesthIntensive Care 1998; 26: 115–116.382 Gibson MP, Vetter T, Crow JP. Use of cont<strong>in</strong>uousretropleural bupivaca<strong>in</strong>e <strong>in</strong> postoperativepa<strong>in</strong> management for pediatricthoracotomy. J Pediatr Surg 1999; 34: 199–201.383 Matsota P, Livanios S, Mar<strong>in</strong>opoulou E.Intercostal nerve block with Bupivaca<strong>in</strong>e forpost-thoracotomy pa<strong>in</strong> relief <strong>in</strong> children.Eur J Pediatr Surg 2001; 11: 219–222.384 Lynn AM, Nespeca MK, Bratton SL et al.Ventilatory effects of morph<strong>in</strong>e <strong>in</strong>fusions <strong>in</strong>cyanotic versus acyanotic <strong>in</strong>fants after thoracotomy.Paediatr Anaesth 2003; 13: 12–17.385 Morton N, Errera A. APA national audit ofpediatric opioid <strong>in</strong>fusions. Pediatr Anesth2010; 20: 119–125.386 Klimek M, Ubben JF, Ammann J et al.Pa<strong>in</strong> <strong>in</strong> neurosurgically treated patients: aprospective observational study. J Neurosurg2006; 104: 350–359.387 Teo JH, Palmer GM, Davidson AJ. Postcraniotomypa<strong>in</strong> <strong>in</strong> a paediatric population.Anaesth Intensive Care 2011; 39: 89–94.388 Warren DT, Bowen-Roberts T, Ou C et al.Safety <strong>and</strong> efficacy of cont<strong>in</strong>uous morph<strong>in</strong>e<strong>in</strong>fusions follow<strong>in</strong>g pediatric cranial surgery<strong>in</strong> a surgical ward sett<strong>in</strong>g. Childs Nerv Syst2010; 26: 1535–1541.389 Ou CHK, Kent SK, Hammond AM et al.Morph<strong>in</strong>e <strong>in</strong>fusions after pediatric cranialsurgery: a retrospective analysis of safety<strong>and</strong> efficacy. Can J Neurosci Nurs 2008; 30:21–30.390 Chiaretti A, Viola L, Pietr<strong>in</strong>i D et al. Preemptiveanalgesia with tramadol <strong>and</strong> fentanyl<strong>in</strong> pediatric neurosurgery. Childs NervSyst 2000; 16: 93–99;discussion 100.391 Chiaretti A, Genovese O, Antonelli A et al.Patient-controlled analgesia with fentanil<strong>and</strong> midazolam <strong>in</strong> children with postoperativeneurosurgical pa<strong>in</strong>. Childs Nerv Syst2008; 24: 119–124.392 McEwan A, Sigston PE, Andrews KA et al.A comparison of rectal <strong>and</strong> <strong>in</strong>tramuscularcode<strong>in</strong>e phosphate <strong>in</strong> children follow<strong>in</strong>gneurosurgery. Paediatr Anaesth 2000; 10:189–193.ª 2012 Blackwell Publish<strong>in</strong>g Ltd, Pediatric Anesthesia, 22 (Suppl. 1), 1–79 65
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RecommendationsChildren’s self-re
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In order to assess pain, effective
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