title: Intranasal sufentanil is effective for postoperative analgesia in adults.
abstract: OBJECTIVE
  The aim of this prospective, randomized, double-blind study was to compare two doses of intranasal sufentanil for postoperative analgesia, titrated according to individual requirements based upon a numeric rating scale (NRS) from 0 to 10 for pain.
  
  
  METHODS
  Forty patients, American Society of Anesthesiologists physical status I-II, scheduled for herniorrhaphy or hemorrhoidectomy under general anesthesia, were included when postoperative NRS was > 3. Nurses used a nasal puff device delivering a constant volume. Patients were randomized into two groups: Group A patients received a dose of 0.025 microg x kg(-1) /puff, Group B patients a dose of 0.05 microg x kg(-1) /puff. Puffs were administered as often as needed to obtain NRS < or = 3, with an interval time of five minutes. Hemodynamic, respiratory measures and sedation were recorded every five minutes.
  
  
  RESULTS
  The probability of persistence of pain in Group B was consistently lower than in Group A. After 20 min, 20% of the patients had a NRS score > 3 in Group B, as opposed to 60% in Group A. At 60 min, no patient had a NRS > 3 in Group B, whereas there was a probability of 20% to record a NRS > 3 for Group A. Hemodynamic, respiratory parameters and sedation remained stable with no intergroup differences.
  
  
  CONCLUSIONS
  Nasal administration of 0.050 microg x kg(-1) /puff sufentanil allowed a NRS < 4 to be attained within one hour in all patients, with efficacy achieved after 20 min. These findings suggest that the intranasal route is an effective mode of sufentanil administration for immediate postoperative analgesia in adult patients.
authors.affiliation: Department of Anesthesiology, Erasme Hospital, Free University of Brussels, University of Route de Lennik 808, B-1070 Brussels, Belgium. nmathieu@ulb.ac.be
authors.forename: Nathalie
authors.initials: N
authors.lastname: Mathieu
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cnudde
authors.forename: Edgard
authors.initials: E
authors.lastname: Engelman
authors.forename: Luc
authors.initials: L
authors.lastname: Barvais
mesh_terms: D000281:Administration, Intranasal; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D017409:Sufentanil / Q000008:administration & dosage* / Q000627:therapeutic use; D013599:Systole; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D017409:Sufentanil; D010100:Oxygen