Epidural analgesia for postoperative pain control in children.

Ninety-eight continuous postoperative epidurals were administered to 87 children. The patients were divided into two groups: group I included 63 cases in which a 0.0625-0.25% solution of bupivacaine was continuously administered; group II included 35 cases in which a similar solution of bupivacaine mixed with 2-10 micrograms of fentanyl was administered. The dose of the epidural medication was titrated by the anesthesiologist according to the patient's age and anticipated level of postoperative pain. The average pain score for all patients for the first 48 h was 1.43. Supplemental analgesia averaging 0.132 mg intravenous morphine/kg/8 h was required in 49 cases (41 in group I and eight in group II). In group I, the average dose of supplemental analgesia was 0.144 mg intravenous morphine/kg/8 h, whereas in group II, it was only 0.056 mg intravenous morphine/kg/8 h. Continuous epidural analgesia is effective in controlling postoperative pain, and the addition of fentanyl reduces the need for systemic narcotics.

Internal wall losses of pharmaceutical dusts during closed-face, 37-mm polystyrene cassette sampling.

A current practice for the determination of personal exposures to dusts involves the aspiration of known quantities of air through membrane filters held in 37-mm plastic cassettes. Samples are collected with the cassettes in the closed-face configuration. A major negative bias error has been identified with this sampling procedure for low-level pharmaceutical dusts. For the pharmaceuticals studied, on average, 62% of the active dust collected in each sample was found on the inside surface of the cassette top. Only 22% of the total active ingredient of the dust was found on the filters. The remaining 16% was found on the inside of the cassette bottoms; electrostatic attraction appears to be the reason that pharmaceutical dusts adhere to the inside surface of the cassette. Adherence to the inside surfaces of the polystyrene cassette occurs without regard to the type of material used to seal the two-piece cassette together. The use of shrink wrap versus plastic tape versus using no sealing material had no effect on where or how much of the active ingredient was found on the inside cassette surfaces. Because very little active ingredient was identified in backup cassettes, it is hypothesized that the active ingredient found on the inside of the bottom portion of the cassettes (past the filter and support pad) got there by falling off the filter during filter removal from the cassette prior to analysis. To eliminate both of these errors, an internal cassette extraction procedure was developed that (1) negates the error caused by static charging and (2) eliminates the need for opening the cassettes prior to analysis.(ABSTRACT TRUNCATED AT 250 WORDS)