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  • Print publication year: 2012
  • Online publication date: June 2012

25 - Postoperative pain control in pediatric patients

from Section 4 - Spine surgery for pediatric patients


1. Weldon BC, Connor M, White PF. Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia. Clin J Pain 1993; 9: 26–33.
2. Johnston CC, Strada ME. Acute pain response in infants: A multidimensional description. Pain 1986; 24: 373–82.
3. Gillies ML, Smith LN, Parry-Jones WL. Postoperative pain assessment and management in adolescents. Pain 1999; 79: 207–17.
4. Czarnecki ML, Jandrisevits MD, Theiler SC, Huth MM, Weisman SJ. Controlled-release oxycodone for the management of pediatric postoperative pain. J Pain Symptom Manage 2004; 27: 379–86.
5. Tobias JD. A review of intrathecal and epidural analgesia after spinal surgery in children. Anesth Analg. 2004; 98: 956–65.
6. Raw DA, Beattie JK, Hunter JM. Anaesthesia for spine surgery. Br J Anaesth 2003; 91: 886–904.
7. Dahl JB, Moiniche S. Pre-emptive analgesia. Br Med Bull 2004; 71: 13–27.
8. Lascelles BDX, Waterman AE, Cripps PJ, Livingston A, Hendersen G. Central sensitization as a result of surgical pain: an investigation of the effect of the pre-emptive value of pethidine for ovarian hysterectomy in the rat. Pain 1995; 62: 201–12.
9. Dirks J, Moiniche S, Hilsted KL, Dahl JB. Mechanisms of post-operative pain: clinical indications for a contribution of central sensitization. Anesthesiology 2002; 97: 1591–6.
10. Cassady JF Jr, Lederhaas G, Cancel DD, et al. A randomized comparison of the effects of continuous thoracic epidural analgesia and intravenous patient-controlled analgesia after posterior spinal fusion in adolescents. Reg Anesth Pain Med. 2000; 25: 246–53.
11. O’Hara JF Jr., Cywinski JB, Tetzlaff JE, et al. The effect of epidural versus intravenous analgesia for posterior spinal fusion surgery. Paediatr Anaesth 2004; 14: 1009–15.
12. Gauger VT, Voepel-Lewis TD, Burke CN, et al. Epidural analgesia compared with intravenous analgesia after pediatric posterior spinal fusion. J Pediatr Orthop 2009; 29: 588–93.
13. Sucato DJ, Duey-Holtz A, Elerson E, et al. Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis: a comparison of continuous epidural analgesia and patient-controlled analgesia. Spine 2005; 30: 211–17.
14. Arms DM, Smith JT, Osteyee J, Gartrell A. Postoperative epidural analgesia for pediatric spine surgery. Orthopedics 1998; 21: 539–44.
15. Shaw BA, Watson TC, Merzel DI, et al. The safety of continuous epidural infusion for postoperative analgesia in pediatric spine surgery. J Pediatr Orthop 1996; 16: 374–7.
16. Amaranth L, Andrish JT, Gurd AR, et al. Efficacy of intermittent epidural morphine following posterior spinal fusion in children and adolescents. Clin Orthop Relat Res 1989; 249: 223–6.
17. Adu-Gyamfi Y. Epidural morphine plus bupivacaine for relief of postoperative pain following Harrington rod insertion for correction of idiopathic scoliosis. J Int Med Res 1995; 23: 211–17.
18. Blumenthal S, Min K, Nadig M, et al. Double epidural catheter with ropivacaine versus intravenous morphine: a comparison for postoperative analgesia after scoliosis correction surgery. Anesthesiology 2005; 102: 175–80.
19. Blumenthal S, Borgeat A, Nadig M, et al. Postoperative analgesia after anterior correction of thoracic scoliosis: a prospective X2 randomized study comparing continuous double epidural catheter technique with intravenous morphine. Spine 2006; 31: 1646–51.
20. Saudan S, Habre W, Ceroni D, et al. Safety and efficacy of patient controlled epidural analgesia following pediatric spinal surgery. Paediatr Anaesth 2008; 18: 132–9.
21. Tobias JD, Gaines RW, Lowry KJ, et al. A dual epidural catheter technique to provide analgesia following posterior spinal fusion for scoliosis in children and adolescents. Paediatr Anaesth 2001; 11: 199–203.
22. Ekatodramis G, Min K, Cathrein P, Borgeat A. Use of a double epidural catheter provides effective postoperative analgesia after spine deformity surgery. Can J Anaesth 2002; 49: 173–7.
23. Zaric D, Nydahl PA, Philipson L, et al. The effect of continuous lumbar epidural infusion of ropivacaine (0.1%, 0.2% and 0.3%) and 0.25% bupivacaine on sensory and motor block in volunteers: a double-blind study. Reg Anesth 1996; 21: 14–25.
24. Scott DA, Chamley DM, Mooney PH, et al. Epidural ropivacaine infusion for postoperative analgesia after major lower abdominal surgery: a dose finding study. Anesth Analg 1995; 81: 982–6.
25. Gall O, Aubineau JV, Bernière J, Desjeux L, Murat I. Analgesic effect of low-dose intrathecal morphine after spinal fusion in children. Anesthesiology 2001; 94: 447–52.
26. Moriarty A. Postoperative extradural infusions in children: preliminary data from a comparison of bupivacaine/diamorphine with plain ropivacaine. Paediatr Anaesth 1999; 9: 423–7.
27. Shaw BA, Watson TC, Merzel DI, et al. The safety of continuous epidural infusion for postoperative analgesia in pediatric spine surgery. J Pediatr Orthop 1996; 16: 374–7.
28. Turner A, Lee J, Mitchell R, et al. The efficacy of surgically placed epidural catheters for analgesia after posterior spinal surgery. Anaesthesia 2000; 55: 370–3.
29. Gauger VT, Voepel-Lewis TD, Burke CN, et al. Epidural analgesia compared with intravenous analgesia after pediatric posterior spinal fusion. J Pediatr Orthop 2009; 29: 588–93.
30. Bridwell KH, Lenke LG, Baldus C, Blanke K. Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients. Spine 1998; 23: 324–31.
31. Mineiro J, Weinstein SL. Delayed postoperative paraparesis in scoliosis surgery. Spine 1997; 22: 1668–72.
32. Taylor BA, Webb PJ, Hetreed M, Mulukutla RD, Farrell J. Delayed postoperative paraplegia with hypotension in adult revision scoliosis surgery. Spine 1994; 19: 470–4.
33. Birmingham PK, Wheeler M, Suresh S, et al. Patient-controlled epidural analgesia in children: can they do it? Anesth Analg 2003; 96: 686–91.
34. Cucchiaro G, Dagher C, Baujard C, Dubousset AM, Benhamou D. Side effects of postoperative epidural analgesia in children: a randomized study comparing morphine and clonidine. Paediatr Anaesth 2003; 13: 318–23.
35. Goodarzi M. Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery. Paediatr Anaesth 1999; 9: 419–22.
36. Chaplan SR, Duncan SR, Brodsky JB, et al. Morphine and hydromorphone epidural analgesia. A prospective, randomized comparison. Anesthesiology 1992; 77: 1090–4.
37. Goodarzi M. Comparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery. Paediatr Anaesth 1999; 9: 419–22.
38. Lawhorn CD, Boop F, Brown R, Andelman P. Epidural pain management in the post-rhizotomy patient. Pediatr Neurosurg 1994; 20: 198–202.
39. Aram L, Krane EJ, Kozloski LJ, Yaster M. Tunneled epidural catheters for prolonged analgesia in pediatric patients. Anesth Analg 2001; 92: 1432–8.
40. Hered RW, Cummings J, Helffrich R. Persistent Horner’s syndrome after spinal fusion and epidural analgesia. Spine 1998; 23: 387–90.
41. Purnell RJ. Scoliosis correction and epidural analgesia: prolonged block following Harrington rod insertion. Anaesthesia 1982; 37: 1115–17.
42. Taenzer AH, Clark C. Efficacy of postoperative epidural analgesia in adolescent scoliosis surgery: a meta-analysis. Paediatr Anaesth 2010; 20: 135–43.
43. Wang JK, Nauss LE, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology 1979; 50: 149–51.
44. Dalens B, Tanguy A. Intrathecal morphine for spinal fusion in children. Spine 1998; 13: 494–8.
45. Blackman RG, Reynolds J, Shively J. Intrathecal morphine: dosage and efficacy in younger patients for control of postoperative pain following spinal fusion. Orthopedics 1991; 14: 555–7.
46. Gall O, Aubineau J, Bernière J, et al. Analgesic effect of low-dose intrathecal morphine after spinal fusion in children. Anesthesiology 2001; 94: 447–52.
47. Urban MK, Jules-Elysee K, Urquhart B, et al. Reduction in postoperative pain after spinal fusion with instrumentation using intrathecal morphine. Spine 2002; 27: 535–7.
48. Gibson PR. Anaesthesia for correction of scoliosis in children. Anaesth Intensive Care 2004; 32: 548–59.
49. Crawford MW, Hickey C, Zaarour C, et al. Development of acute opioid tolerance during infusion of remifentanil for pediatric scoliosis surgery. Anesth Analg 2006; 102: 1662–7.
50. Goodarzi M, Shier NH, Grogan DP. Effect of intrathecal opioids on somatosensory-evoked potentials during spinal fusion in children. Spine 1996; 21: 1565–8.
51. Cousins MJ, Mather LE. Intrathecal and epidural administration of opioids. Anesthesiology 1984; 61: 276–310.
52. Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth 1995; 42: 891–903.
53. Nordberg G, Hedner T, Mellstrand T, et al. Pharmacokinetic aspects of intrathecal morphine analgesia. Anesthesiology 1984; 60: 448–54.
54. Tripi PA, Poe-Kochert C, Potzman J, et al. Intrathecal morphine for postoperative analgesia in patients with idiopathic scoliosis undergoing posterior spinal fusion. Spine 2008; 33: 2248–51.
55. Goodarzi M. The advantages of intrathecal opioids for spinal fusion in children. Paediatr Anaesth 1998; 8: 131–4.
56. Milbrandt TA, Singhal M, Minter C, et al. A comparison of three methods of pain control for posterior spinal fusions in adolescent idiopathic scoliosis. Spine 2009; 34: 1499–503.
57. Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth 1995; 42: 891–903.
58. Han DW, Hong SW, Kwon JY, et al. Epidural ondansetron is more effective to prevent postoperative pruritus and nausea than intravenous ondansetron in elective cesarean delivery. Acta Obstet Gynecol Scand 2007; 86: 683–7.
59. Lockington PF, Fa’aea P. Subcutaneous naloxone for the prevention of intrathecal morphine induced pruritus in elective Caesarean delivery. Anaesthesia 2007; 62: 672–6.
60. Gulhas N, Erdil FA, Sagir O, et al. Lornoxicam and ondansetron for the prevention of intrathecal fentanyl-induced pruritus. J Anesth 2007; 21: 159–63.
61. Iatrou CA, Dragoumanis CK, Vogiatzaki TD, et al. Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study. Anesth Analg 2005; 101: 1516–20.
62. Poe-Kochert C, Tripi PA, Potzman J, Son-Hing JP, Thompson GH. Continuous intravenous morphine infusion for postoperative analgesia following posterior spinal fusion for idiopathic scoliosis. Spine 2010; 35: 754–7.
63. Berde CB, Solodiuk J. Multidisciplinary programs for management of acute and chronic pain in children. In: Schechter NI, Berde CB, Yaster M, eds. Pain in Infants, Children and Adolescents. Philadelphia: Lippincott Williams & Wilkins, 2003.
64. Voepel-Lewis T, Marinkovic A, Kostrzewa A, et al. The prevalence and risk factors for adverse events in children receiving patient-controlled analgesia by proxy or patient-controlled analgesia. Anesth Analg 2008; 107: 70–5.
65. McDonald AJ, Cooper MG. Patient-controlled analgesia: an appropriate method of pain control in children. Paediatr Drugs 2001; 3: 273–84.
66. Beaulieu P, Cyrenne L, Mathews S, et al. Patient-controlled analgesia after spinal fusion for idiopathic scoliosis. Int Orthop 1996; 20: 295–9.
67. Rauen KK, Ho M. Children’s use of patient-controlled analgesia after spine surgery. Pediatr Nurs 1989; 15: 589–93, 637.
68. Goodarzi M, Shier NH, Ogden JA. Epidural versus patient-controlled analgesia with morphine for postoperative pain after orthopaedic procedures in children. J Pediatr Orthop 1993; 13: 663–7.
69. Weinger MB. Dangers of postoperative opioids: APSF [Anesthesia Patient Safety Foundation] workshop and white paper addresses prevention of postoperative complications. APSF Newsletter 2006.
70. Woolf CJ, Chong MS. Preemptive analgesic – treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993; 77: 362–79.
71. Rusy LM, Troshynski TJ, Weisman SJ. Gabapentin in phantom limb pain management in children and young adults: report of seven cases. J Pain Symptom Manage 2001; 21: 78–82.
72. Bone M, Critchley P, Buggy D. Gabapentin in post amputation phantom limb pain: a randomized, double blind, placebo controlled, cross-over study. Reg Anesth Pain Med 2002; 27: 481–6.
73. Backonja NM. Gabapentin monotherapy for the symptomatic treatment of painful neuropathy: a multicenter, double blind, placebo controlled trial in patients with diabetes mellitus. Epilepsia 1999; 40: S57–9.
74. Pandey CK, Bose N, Garg G, et al. Gabapentin for the treatment of pain in Guillain–Barré syndrome: a double blind, placebo controlled, cross-over study. Anesth Analg 2002; 95: 1719–23.
75. Menigaux C, Adam F, Guignard B, Sessler DI, Chauvin M. Preoperative gabapentin decreases anxiety and improves early recovery from knee surgery. Anesth Analg 2005; 100: 1394–9.
76. Fassoulaki A, Patris K, Sarantopoulos C, Hogan Q. The analgesic effect of gabapentin and mexiletine after breast surgery for cancer. Anesth Analg 2002; 95: 985–91.
77. Rusy LM, Hainsworth KR, Nelson TJ, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg 2010; 110: 1393–8.
78. Anderson BJ, Holford NH, Wollard GA, et al. Perioperative pharmacodynamics of acetaminophen analgesia in children. Anesthesiology 1999; 90: 411–21.
79. American Academy of Pediatrics: Committee on Drugs. Acetaminophen toxicity in children. Pediatrics 2001; 108: 1020–4.
80. Mayoral CE, Marino RV, Rosenfeld W, et al. Alternating antipyretics: Is this an alternative?” Pediatrics 2000; 105: 1009–12.
81. Aleksandrovich Iu S, Sukhanov Iu V, Volykhin IV. [Evaluation of the efficacy of paracetamol as a component of postoperative combined analgesia in children]. [Article in Russian]. Anesteziol Reanimatol 2009; 1: 58−62.
82. Duggan ST, Scott LJ. Intravenous paracetamol (acetaminophen). Drugs 2009; 69: 101–13.
83. Souter AJ, Fredman B, White PF. Controversies in the perioperative use of non-steroidal antiinflammatory drugs. Anesth Analg 1994; 79: 1178–90.
84. Dahl JB, Kehlet H. Non-steroidal anti-inflammatory drugs: rationale for use in severe postoperative pain. Br J Anaesth 1991; 66: 703–12.
85. Kinsella J, Moffat AC, Patrick JA, et al. Ketorolac trometamol for postoperative analgesia after orthopaedic surgery. Br J Anaesth 1992; 69: 19–22.
86. Gillis JC, Brogden RN. Ketorolac. A reappraisal of its pharmacodynamic and pharmacokinetic properties and therapeutic use in pain management. Drugs 1997; 53: 139–88.
87. Sevarino FB, Sinatra RS, Paige D, et al. Intravenous ketorolac as an adjunct to patient-controlled analgesia (PCA) for management of postgynecologic surgical pain. J Clin Anesth 1994; 6: 23–7.
88. Sutters KA, Shaw BA, Gerardi JA, et al. Comparison of morphine patient-controlled analgesia with and without ketorolac for postoperative analgesia in pediatric orthopedic surgery. Am J Orthop 1999; 28: 351–8.
89. Picard P, Bazin JE, Conio N, et al. Ketorolac potentiates morphine in postoperative patient-controlled analgesia. Pain 1997; 73: 401–6.
90. Le Roux PD, Samudrala S. Postoperative pain after lumbar disc surgery: a comparison between parenteral ketorolac and narcotics. Acta Neurochir (Wien) 1999; 141: 261–7.
91. Munro HM, Walton SR, Malviya S, et al. Low-dose ketorolac improves analgesia and reduces morphine requirements following posterior spinal fusion in adolescents. Can J Anaesth 2002; 49: 461–6.
92. Gajraj NM. Cyclooxygenase-2 inhibitors. Anesth Analg 2003; 96: 1720–38.
93. Gillis JC, Brogden RN. Ketorolac. A reappraisal of its pharmacodynamic and pharmacokinetic properties and therapeutic use in pain management. Drugs 1997; 53: 139–88.
94. Saag KG, Cowdery JS. Nonsteroidal anti-inflammatory drugs. Balancing benefits and risks. Spine 1994; 19: 1530–4.
95. Connelly CS, Panush RS. Should nonsteroidal anti-inflammatory drugs be stopped before elective surgery? Arch Intern Med 1991; 151: 1936–46.
96. Feldman HI, Kinman JL, Berlin JA, et al. Parenteral ketorolac: the risk for acute renal failure. Ann Intern Med 1997; 126: 193–9.
97. Nuutinen LS, Laitinen JO, Salomaki TE, et al. A risk-benefit appraisal of injectable NSAIDs in the management of postoperative pain. Drug Saf 1993; 9: 380–93.
98. Toto RD, Anderson SA, Brown-Cartwright D, et al. Effects of acute and chronic dosing of NSAIDs in patients with renal insufficiency. Kidney Int 1986; 30: 760–8.
99. Kenny GN. Potential renal, haematological and allergic adverse effects associated with nonsteroidal anti-inflammatory drugs. Drugs 1992; 44: 31–6.
100. Strom BL, Berlin JA, Kinman JL, et al. Parenteral ketorolac and risk of gastro-intestinal and operative site bleeding: a postmarketing surveillance study. JAMA 1996; 275: 376–82.
101. RuDusky BM. Severe postoperative hemorrhage attributed to single-dose parenteral ketorolac-induced coagulopathy. Angiology 2000; 51: 999–1002.
102. Kallis P, Tooze JA, Talbot S, et al. Preoperative aspirin decreases platelet aggregation and increases post-operative blood loss – a randomized, placebo-controlled, double-blind clinical trial in 100 patients with chronic stable angina. Eur J Cardiothorac Surg 1994; 8: 404–9.
103. Haws MJ, Kucan JO, Roth AC, et al. The effects of chronic ketorolac tromethamine (toradol) treatment on wound healing. Ann Plast Surg 1996; 37: 147–51.
104. Dimar JR, Ante WA, Zhang YP, et al. The effects of nonsteroidal anti-inflammatory drugs on posterior spinal fusions in the rat. Spine 1996; 21: 1870–6.
105. Keller J, Bunger C, Andreassen TT, et al. Bone repair inhibited by indomethacin. Effects on bone metabolism and strength of rabbit osteotomies. Acta Orthop Scand 1987; 58: 379–83.
106. Martin GJ, Boden SD, Titus L. Recombinant human bone morphogenetic protein-2 overcomes the inhibitory effect of ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), on posterolateral lumbar intertransverse process spine fusion. Spine 1999; 24: 2188–93; discussion 2193–4.
107. Reikeraas O, Engebretsen L. Effects of ketoralac tromethamine and indomethacin on primary and secondary bone healing. An experimental study in rats. Arch Orthop Trauma Surg 1998; 118: 50–2.
108. Ho ML, Chang JK, Wang GJ. Effects of ketorolac on bone repair: a radiographic study in modeled demineralized bone matrix grafted rabbits. Pharmacology 1998; 57: 148–59.
109. Sucato DJ, Lovejoy JF, Agrawal S, et al. Postoperative ketorolac does not predispose to pseudoarthrosis following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Spine 2008; 33: 1119–24.
110. Glassman SD, Rose SM, Dimar JR, et al. The effect of postoperative nonsteroidal anti-inflammatory drug administration on spinal fusion. Spine 1998; 23: 834–8.
111. Pradhan BB, Tatsumi RL, Gallina J, et al. Ketorolac and spinal fusion: does the perioperative of ketorolac really inhibit spinal fusion? Spine 2008; 19: 2079–82.
112. Camu F, Lauwers MH, Vanlersberghe C. Side effects of NSAIDs and dosing recommendations for ketorolac. Acta Anaesthesiol Belg 1996; 47: 143–9.
113. Gupta A, Daggett C, Ludwick J, et al. Ketorolac after congenital heart surgery: does it increase the risk of significant bleeding complications? Paediatr Anaesth 2005; 15: 139–42.
114. Gupta A, Daggett C, Drant S, et al. Prospective randomized trial of ketorolac after congenital heart surgery. J Cardiothorac Vasc Anesth 2004; 18: 454–7.
115. Vitale MG, Choe JC, Hwang MW, et al. Use of ketorolac tromethamine in children undergoing scoliosis surgery: an analysis of complications. Spine J 2003; 3: 55–62.
116. Chauhan RD, Idom CB, Noe HN. Safety of ketorolac in the pediatric population after ureteroneocystostomy. J Urol 2001; 166: 1873–5.
117. Patrono C, Dunn MJ. The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int 1987; 32: 1.
118. Oates JA, FitzGerald GA, Branch RA, et al. Clinical implications of prostaglandin and thromboxane A2 formation (2). N Engl J Med 1988; 319: 761.
119. Huerta C, Castellsague J, Varas-Lorenzo C, García Rodríguez LA. Nonsteroidal anti-inflammatory drugs and risk of ARF in the general population. Am J Kidney Dis 2005; 45: 531.
120. Rose BD, Post TW. Clinical Physiology of Acid–Base and Electrolyte Disorders. 5th ed. New York: McGraw-Hill; 2001: 192–6.
121. Murray MD, Brater DC. Renal toxicity of the nonsteroidal anti-inflammatory drugs. Annu Rev Pharmacol Toxicol 1993; 33: 435.
122. Takahashi K, Schreiner GF, Yamashita K, et al. Predominant functional roles for thromboxane A2 and prostaglandin E2 during late nephrotoxic serum glomerulonephritis in the rat. J Clin Invest 1990; 85: 1974.
123. Feldman HI, Kinman JL, Berlin JA, et al. Parenteral ketorolac: the risk for acute renal failure. Ann Intern Med 1997; 126: 193.
124. Gajraj NM, Joshi GP. Role of cyclooxygenase-2 inhibitors in postoperative pain management. Anesthesiology Clin N Am 2005; 23: 49–72.
125. Blumenkopf B. Combination analgesic-antispasmodic therapy in postoperative pain. Spine (Phila Pa 1976) 1987; 12: 384–7.
126. Olkkola KT, Hamunen K, Maunuksela EL. Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children. Clin Pharmacokinet 1995; 28: 385–404.
127. Lo MW, Schary WL, Whitney CCJ. The disposition and bioavailability of intravenous and oral nalbuphine in healthy volunteers. J Clin Pharmacol 1987; 27: 866–73.
128. Lo MW, Lee FH, Schary WL, Whitney CCJ. The pharmacokinetics of intravenous, intramuscular, and subcutaneous nalbuphine in healthy subjects. Eur J Clin Pharmacol 1987; 33: 297–301.
129. Sear JW, Keegan M, Kay B. Disposition of nalbuphine in patients undergoing general anaesthesia. Br J Anaesth 1987; 59: 572–5.
130. Jaillon P, Gardin ME, Lecocq B, et al. Pharmacokinetics of nalbuphine in infants, young healthy volunteers, and elderly patients. Clin Pharmacol Ther 1989; 46: 226–33.
131. Kjellberg F, Tramer MR. Pharmacological control of opioid-induced pruritus: a quantitative systematic review of randomized trials. Eur J Anaesthesiol 2001; 18: 346–57.
132. Cohen SE, Ratner EF, Kreitzman TR, et al. Nalbuphine is better than naloxone for treatment of side effects after epidural morphine. Anesth Analg 1992; 75: 747–52.
133. Johnson C, Mayer P, Grosz D. Pulmonary edema following naloxone administration in a healthy orthopedic patient. J Clin Anesth 1995; 7: 356–7.
134. O’Malley-Dafner L, Davies P. Naloxone- induced pulmonary edema. Am J Nurs 2000; 100: 24AA–JJ.
135. Maxwell LG, Kaufmann SC, Bitzer S, et al. The effects of a small-dose naloxone infusion on opioid-induced side effects and analgesia in children and adolescents treated with intravenous patient-controlled analgesia: a double-blind, prospective, randomized, controlled study. Anesth Analg 2005; 100: 953–8.
136. Dayer P, Desmeules J, Collart L. Pharmacology of tramadol. Drugs 1997; 53: 18–24.
137. Raffa RB, Friderichs E, Reimann W, et al. Opioid and nonopioid components independently contribute to the mechanism of action of tramadol, an “atypical” opioid analgesic. J Pharmacol Exp Ther 1992; 260: 275–85.
138. Bamigbade TA, Langford RM. The clinical use of tramadol hydrochloride. Pain Reviews 1998; 5: 155–82.
139. Houmes RM, Voets MA, Verkaaik A, et al. Efficacy and safety of tramadol versus morphine for moderate and severe postoperative pain with special regard to respiratory depression. Anesth Analg 1992; 74: 510–14.
140. Vickers MD, O’Flaherty D, Szekely SM, et al. Tramadol: pain relief by an opioid without depression of respiration. Anaesthesia 1992; 47: 291–6.
141. Tarkkila P, Tuominen M, Lindgren L. Comparison of respiratory effects of tramadol and oxycodone. J Clin Anesth 1997; 19: 582–5.