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Pain control with low-dose alfentanil in children undergoing minor abdominal and genito-urinary surgery

Published online by Cambridge University Press:  23 December 2004

F. Leoni ,
F. Benni ,
T. Iacobucci  and
G. de Francisci
F. Leoni
Affiliation:
Catholic University of Sacred Heart, Istituto di Anestesiologia e Rianimazione, Rome, Italy
F. Benni
Affiliation:
Catholic University of Sacred Heart, Istituto di Anestesiologia e Rianimazione, Rome, Italy
T. Iacobucci
Affiliation:
Catholic University of Sacred Heart, Istituto di Anestesiologia e Rianimazione, Rome, Italy
G. de Francisci
Affiliation:
Catholic University of Sacred Heart, Istituto di Anestesiologia e Rianimazione, Rome, Italy
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Abstract

Summary

Background and objective: The aim of this study was to investigate the quality of intra- and postoperative analgesia obtained by alfentanil compared to that produced by peripheral blockade in children.

Methods: During sevoflurane-nitrous oxide atracurium anaesthesia for minor abdominal or genito-urinary surgery, three groups of children aged 0–8 yr received 25 μg kg−1 alfentanil intravenously (n = 28), or peripheral nerve blockade using 1 mL−1 ropivacaine 0.475% (n = 24), or 12.5 μg kg−1 alfentanil intravenously with peripheral nerve blockade using 1 mL kg−1 ropivacaine 0.475% (n = 30). Changes in blood pressure and heart rate were measured during the procedures. Postoperative pain was assessed using the face, legs, activity, cry, consolability (FLACC) observational tool for quantifying pain behaviour and a numerical scale scored by nurses, doctors, parents and children.

Results: There was no significant difference in intra- or postoperative analgesic efficacy among the three groups. Patients who received alfentanil had significantly lower heart rates than those who received nerve blockade only (96.0 ± 15.6 vs. 115.9 ± 23.2 beats min−1, P < 0.001). FLACC and numerical scale scores did not differ among the groups. There were no significant differences in incidence of vomiting or use of pain medications.

Conclusions: It was concluded that a low-dose, intravenous bolus of alfentanil may be an efficient alternative to peripheral nerve blockade in controlling pain during and after minor abdominal and genito-urinary surgery.

Keywords

ANAESTHESIA, anaesthesia local, anaesthesia generalPAEDIATRICS ANALGESICS, OPIOID, alfentanilANAESTHETICS, LOCAL, ropivacainePAIN, POSTOPERATIVE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 9 , September 2004 , pp. 738 - 742
Copyright
2004 European Society of Anaesthesiology

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