• Jennifer A Rabbitts, Cornelius B Groenewald, and Jukka Räsänen.
• Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital and University of Washington, 4800 Sand Point Way NE, Seattle, WA 98105, USA. jennifer.rabbitts@seattlechildrens.org
• Paediatr Anaesth. 2012 Jul 1; 22 (7): 676-81.

ObjectivesTo investigate whether geographic differences exist in perioperative opioid administration to children.Aim  To investigate whether perioperative fentanyl use for cleft lip and palate surgery varies between children of three different geographic regions.BackgroundDifferences have been found in perioperative opioid administration to children of differing ethnicity in the USA. Whether similar differences exist in perioperative opioid administration to children residing in different geographic regions is unknown.Methods/MaterialsWe retrospectively reviewed the medical records of ASA I children who underwent surgery under standardized general anesthesia between January 2010 and April 2011 during SMILE Network International mission trips to Africa, India and Central and South America. Perioperative administration of fentanyl was compared between these three locations.ResultsWe analyzed data from 79 children who underwent surgery in Africa, 76 in India and 153 in Central and South America. Children in Central and South America were given <50% of the intraoperative amount of fentanyl (2.0 ± 1.2 mcg·kg(-1) ) administered to children in Africa (4.1 ± 2.4 mcg·kg(-1) ; P < 0.001) and children in India (4.3 ± 2.2 mcg·kg(-1) ; P < 0.001). Postoperatively, fentanyl was administered in equivalent doses to all groups.ConclusionsChildren in Central and South America received less opioid intraoperatively than African and Indian children, under standardized anesthesia for cleft surgeries. Further research is necessary to elucidate the mechanisms underlying these group differences.© 2012 Blackwell Publishing Ltd.

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