Intravenous versus epidural analgesia with fentanyl in paediatric laparoscopic surgeries

Laparoscopic surgery offers children and newborns a significant number of advantages, including a reduction in pain and cosmetic injury that facilitates early ambulation and a rapid return to normal activities. Although the surgery is of a minimally invasive nature, there are a number of specific physiological alterations occurring as a result of creating the pneumoperitoneum and the postural changes involved in optimizing patient position. Cardiovascular an hemodynamic changes associated with laparoscopic procedure is most significant in infant and child. A study was conucted in patients between 6 month to 6 years age group devided in two group, one group received intravenous fentanyl and other group received epidural fentanyl along with ropivacaine and intraoperative and postoperative hemodynamic stability was compared. It was concluded that epidural analgesia group was more hemodynamically stable and less requirement of rescue analgesia.