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Issue title: Cerebral Palsy
Guest editors: Rachel Byrne, Deborah Gaebler-Spira, Michael Green and Heakyung Kim
Article type: Research Article
Authors: Pennington, Jareda; * | Contini, Shawnellea | Brown, Miraidesa | Goel, Nupurb | Chen, Tsuleea
Affiliations: [a] Akron Children’s Hospital, Akron, OH, USA | [b] Northeast Ohio Medical University, Rootstown, OH, USA
Correspondence: [*] Corresponding author: Jared Pennington, Akron Children’s Hospital, 215 W. Bowery Street Level 4, Akron, OH 44308, USA. E-mail: jpennington@akronchildrens.org.
Abstract: PURPOSE:The purpose of this study was to evaluate the effectiveness of intrathecal morphine following selective dorsal rhizotomy in pediatric patients previously diagnosed with cerebral palsy. METHODS:This was a retrospective, cohort analysis over the course of four years. The analysis consisted of a treatment group which received intrathecal morphine (5 mcg/kg) injection and a control group that did not receive the injection prior to dural closure. All patients underwent multilevel laminectomies for selective dorsal rhizotomy at Akron Children’s Hospital. The effectiveness of the treatment was measured by total dose of hydromorphone administered on patient-controlled analgesia (PCA), number of days on oral narcotics, and cumulative dose of oral narcotic. RESULTS:Of the analyzed 15 pediatric patients, seven patients received intrathecal morphine injection while the other eight did not receive the treatment prior to dural closure. There was a difference of 1135 mcg in total PCA dose between the study group (3243 mcg) and the control group (4378 mcg). The total PCA dose based on weight was lower in the study group (163 mcg/kg) than in the control group (171 mcg/kg). CONCLUSION:Based on these findings, the administration of intrathecal morphine clinically reduces the opiate need in the first 96 hours post-operatively.
Keywords: Cerebral palsy, selective dorsal rhizotomy, pain control, intrathecal morphine
DOI: 10.3233/PRM-220048
Journal: Journal of Pediatric Rehabilitation Medicine, vol. 16, no. 1, pp. 109-114, 2023
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