[Side Effects of Continuous Fentanyl Infusion for Postoperative Pain Relief in Children].

BACKGROUND: There have been many reports on the use of morphine for postoperative pain relief in children, but the use of fentanyl for this purpose has not frequently been described. We clarified the details of side effects exhibited in children who had received continuous fentanyl infusion for postoperative pain relief METHODS: The subjects are 1,166 children aged between 0 and 14 years who underwent continuous fentanyl infusion for postoperative pain relief within the previous 4 years. Fentanyl was administered at a dose of 0.5 or 1.0 µg x kg(-1) x hr(-1), and with continuous use of pulse oximeter, the pulse rate, SpO2, respiratory rate, BP, sedation score, and presence/absence of nausea/vomiting were recorded every 2 hours. The frequencies of side effects were retrospectively examined. RESULTS: Severe side effects, including respiratory depression, for which mask ventilation or tracheal intubation was required were observed in 0.77% of cases. No subjects died or developed permanent sequelae. Nausea/vomiting occurred in 25.4% of cases. CONCLUSIONS: Using monitoring systems that facilitate the early detection of and intervention in respiratory depression, we can safely administer continuous fentanyl infusion for postoperative pain relief in children. It is necessary to adopt countermeasures against nausea/vomiting.

[General anesthesia for pediatric cardiac magnetic resonance imaging].

The performance of MRI in children under 5 or 6 years of age usually requires sedation. Cardiac MRI takes even longer time to perform than regular MRI and such patients have cardiac diseases. It is therefore desirable for anesthesiologists to secure the airway and pay close attention to patients'vital signs. We perform general anesthesia for cardiac MRI using non-MRI-compatible monitors and anesthesia machines at our institution, and we therefore use appropriate devices to perform MRI safely. For that purpose, we either obtain peripheral intravenous access or perform tracheal intubation outside the MRI scan room and use extension cables for monitoring the patient.