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Adenotonsillectomy in children: a comparison of morphine and fentanyl for peri‐operative analgesia*
Author(s) -
Mukherjee K.,
Esuvaranathan V.,
Streets C.,
Johnson A.,
Carr A. S.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2001.2084-4.x
Subject(s) - fentanyl , medicine , anesthesia , morphine , vomiting , propofol , isoflurane , analgesic , nausea , incidence (geometry) , surgery , physics , optics
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 µ g.kg −1 intra‐operatively or intramuscular morphine 100 µ g.kg −1 at induction. All children received a standard anaesthetic induction with intravenous fentanyl 1 µ g.kg −1 and propofol 4–5 mg.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.