Adenotonsillectomy in children: a comparison of morphine and fentanyl for
peri-operative analgesia.
Author(s): Mukherjee K, Esuvaranathan V, Streets C, Johnson A, Carr AS.
Affiliation(s): Derriford Hospital, Plymouth PL6 8DH, UK.
Publication date & source: 2001, Anaesthesia. , 56(12):1193-7
This study compared the effectiveness and side-effects of intra-operative
fentanyl with fentanyl and morphine for elective adenotonsillectomy in a
double-blind study, in 60 children randomly allocated to receive either
intravenous fentanyl 1 microg x kg(-1) intra-operatively or intramuscular
morphine 100 microg x kg(-1) at induction. All children received a standard
anaesthetic induction with intravenous fentanyl 1 microg x kg(-1) and propofol
4-5 mg x kg(-1) and maintenance with oxygen, nitrous oxide and isoflurane. Pain
scores, emetic episodes and supplemental morphine requirements were recorded for
24 h postoperatively. The overall incidence of postoperative vomiting was high in
both groups: 70% in the fentanyl group and 78% in the morphine group. The
incidence of postoperative vomiting was lower in the fentanyl group (p < 0.03) in
the first 4 h, but similar by 24 h. Children who received morphine at any time in
the first 24 h had more median (range) episodes of vomiting [2 (0-7)] than
children receiving fentanyl only [l (0-3); p < 0.03]. Administration of rescue
anti-emetics, pain scores in recovery and pain scores over the next 24 h were
similar between the two groups.
Erratum in
Anaesthesia 2002 Feb;57(2):208.
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