Parent-assisted or nurse-assisted epidural analgesia: is this feasible in pediatric patients?


Journal Article

AIM: The aim of this study was to assess the feasibility of parent-assisted or nurse-assisted epidural analgesia (PNEA) for control of postoperative pain in a pediatric surgical population. METHODS: After the institutional review board (IRB) approval was obtained, an analysis of our pain treatment services database of pediatric surgical patients with epidural catheters in whom the parent and/or nurse were empowered to activate the epidural demand-dose button was evaluated. RESULTS: Over a 10 -year period between 1999 and 2008, 128 procedures in 126 patients were provided parent or nurse assistance of the epidural demand dose. Satisfactory analgesia was obtained in 86% of patients with no or minor adjustments in PNEA parameters. Fourteen percent of patients were converted to intravenous patient-controlled analgesia (PCA) for inadequate analgesia (7%) or side effects (7%). None of the patients in this cohort required treatment for respiratory depression or excessive sedation. CONCLUSIONS: Parent-assisted or nurse-assisted epidural analgesia can be safely administered to children undergoing surgery who are physically or cognitively unable or unwilling to self-activate a demand dose. Additional studies are needed to compare the efficacy of PNEA with other modalities for postoperative pain control in children.

Full Text

Cited Authors

  • Birmingham, PK; Suresh, S; Ambrosy, A; Porfyris, S

Published Date

  • November 2009

Published In

Volume / Issue

  • 19 / 11

Start / End Page

  • 1084 - 1089

PubMed ID

  • 19807886

Pubmed Central ID

  • 19807886

Electronic International Standard Serial Number (EISSN)

  • 1460-9592

International Standard Serial Number (ISSN)

  • 1155-5645

Digital Object Identifier (DOI)

  • 10.1111/j.1460-9592.2009.03151.x


  • eng