Objective: To observe the effectiveness and adverse reactions of fentanyl used by nasal infusion or intravenous injection in post-operative analgesia in pediatric patients.
Methods: Forty 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.
Results: The 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.
Conclusion: There 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.