• Xiang Cheng and Jing-hui Li.
• Department of Anesthesiology, Haikou Hospital, Xiangya Medical College of Central South University, Haikou 570208, China.
• Zhonghua Yi Xue Za Zhi. 2008 Nov 11;88(41):2898-900.

ObjectiveTo observe the effectiveness and adverse reactions of fentanyl used by nasal infusion or intravenous injection in post-operative analgesia in pediatric patients.MethodsForty children, underwent selective lower abdomen surgery under intravenous anesthesia. At the end of operation, 36 patients with the scores > 6 according to the Objective Pain Scale (OPS) were randomly divided into 2 groups, Group A (n = 17) undergoing nasal administration of fentanyl 0.5 microg/kg, then intravenous injection of 1 ml 0.9% sodium chloride, Group B group (n = 19) undergoing nasal administration of 1 ml 0.9% sodium chloride and then intravenous injection of fentanyl 0.5 microg/kg. Five min later pain scoring was conducted. Those with the OPS score > or = 2 received the same protocol once, and then scoring was conducted every 1 min. Another 5 min later the same protocol was used to those still with the OPS score > or = 2 once again. Such a protocol was continued till the OPS score < or = 2. Sixty min after the first administration, the primary scheme was carried out once per hour until 24 h later.ResultsThe time needed to achieve the OPS score < or = 2 of Group A was (16 +/- 5) min, not significantly different from that of Group B [(14 +/- 5) min, P > 0.05]. The amount of fentanyl used in Group A was (21 +/- 5) microg, significantly higher than that of Group B [(15 +/- 7) microg, P < 0.05]. When the OPS score < or = 2 was achieved the dizziness rate of Group B was 31.58%, and the nausea /vomiting rate of Group B was 21.05%, both significantly higher than those of Group A (11.76% and 31.58% respectively, both P < 0.05), however, there were significant differences in the adverse reaction rates since 12 h after the first administration. There were no significant differences in the OPS score 4 h after the first administration.ConclusionThere are not significant differences in the time needed to achieve the analgesic effect in the pediatric children who undergo lower abdomen surgery. Nasal administration of fentanyl needs a higher dose with a higher comfort and lower adverse reaction rate.

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