Geographic differences in perioperative opioid administration in children.
OBJECTIVE
To investigate whether geographic differences exist in perioperative opioid administration to children.


OBJECTIVE
To investigate whether perioperative fentanyl use for cleft lip and palate surgery varies between children of three different geographic regions.


BACKGROUND
Differences 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
We 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.


RESULTS
We 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.


CONCLUSIONS
Children 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.
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
Jennifer A
JA
Rabbitts
Cornelius B
CB
Groenewald
Jukka
J
Räsänen
D000367:Age Factors; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D004363:Drug Utilization; D004484:Ecuador / Q000453:epidemiology; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D005843:Geography; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007391:International Cooperation; D007630:Kenya / Q000453:epidemiology; D008800:Mexico / Q000453:epidemiology; D059408:Pain Management / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000188:drug therapy; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D014454:Uganda / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D005283:Fentanyl