Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children.
BACKGROUND
Studies comparing epidural fentanyl and sufentanil in adults reported a similar analgesic effect with variable side effects. We hypothesized that epidural fentanyl and sufentanil will have a similar analgesic effect in children undergoing urological surgery.


METHODS
Sixty-four children undergoing urological surgery were randomized into two groups: fentanyl in ropivacaine (fentanyl group, n=32) and sufentanil in ropivacaine (sufentanil group, n=32). After anaesthesia, an epidural catheter was inserted at the L2-3, L3-4 or L4-5 interspace. For post-operative pain relief, a solution consisting of fentanyl 0.1 mcg/kg/ml or sufentanil 0.015 mcg/kg/ml in 1.5 mg/ml ropivacaine was infused at a rate of 2 ml/h. To assess post-operative pain, the faces pain scale and the face, legs, activity, cry, consolability score were recorded at 1, 6, 24, 48 and 72 h after surgery. The incidence of adverse effects such as hypoxia, sedation, pruritus, nausea and/or vomiting was also evaluated.


RESULTS
Pain scores demonstrated no significant difference between the groups. The need for rescue analgesia during 24-72 h was higher in the fentanyl group than in the sufentanil group (6/32 vs. 0/32, P=0.012). The incidence of pruritus was higher in the sufentanil group compared with that in the fentanyl group (5/32 vs. 0/32).


CONCLUSIONS
Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in infants and children undergoing urological surgery. The incidence of pruritus in the sufentanil group was higher than that in the fentanyl group.
Cho
J E
JE
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea.
Kim
J Y
JY
Kim
J E
JE
Chun
D H
DH
Jun
N H
NH
Kil
H K
HK
D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D017409:Sufentanil; D005283:Fentanyl