Local anesthetic infiltration of the wound for supplemental postoperative pain management in a pediatric liver transplant patient.

Introduction: We previously reported a case using caudal morphine for pediatric liver transplantation. A 3-yr-old, 14.9 kg child received a caudal injection of 0.6 mg of preservative free morphine sulfate as well as 110 mcg of intravenous fentanyl. Also, the surgical incisions were infiltrated with 20 ml of 0.125% bupivacaine1. However, a question arose as to the impact of the local anesthetic on the patient’s postoperative course and narcotic requirements. Therefore, we report the use of local anesthetic infiltration of the wound for supplemental postoperative pain management and compare this experience to the previously reported case in terms of postoperative pain, narcotic requirements, and potential patient benefits.