Effectiveness of Sufentanil-Based Patient-Controlled Analgesia Regimen in Children and Incidence of Adverse Events Following Major Congenital Structure Repairs.

Abstract

The aim of this study was to evaluate postoperative analgesia effectiveness and patient-controlled analgesia (PCA)-related adverse events. The children who received sufentanil-based PCA following major surgery to repair congenital hip dislocation and hypospadias were divided into 3 groups: sufentanil 4 µg/kg + tramadol 10 mg/kg (ST; n = 301), sufentanil 4 µg/kg (S4; n = 211), and sufentanil 5 µg/kg (S5; n = 451). Analgesics with granisetron 0.2 mg/kg were diluted in 0.9% saline to 100 mL and infused continuously at a basal infusion rate of 1 mL/h. A total of 963 children whose average age was 4 years were investigated. The incidence of moderate to severe postoperative pain during rest was significantly lower in the S5 group (0.2%) and ST group (0.3%) compared with the S4 group (3.3%) within 72 hours after surgery (P < .05), and the incidence of moderate to severe pain during activity within 72 hours was also significantly lower in the S5 group (3.5%) compared with the other 2 groups (ST, 21.9%; S4, 33.2%; P < .001). A significant difference was identified among the 3 groups in the total number of PCA administrations, but there was no statistical difference of total usage of opioids among the 3 groups. In terms of PCA-related adverse events, the incidence of postoperative nausea and vomiting in the S5 group was lower compared with the ST group within 72 hours after surgery (P < .001), and there was no significant difference compared with the S4 group (P = .254). There was also no significant difference in the incidence of pruritus and dizziness among the 3 groups. Sufentanil-based PCA can be effectively and safely used in children after major congenital structural malformation repair surgeries. The sufentanil 5 µg/kg dosage in the PCA regimen is superior to sufentanil 4 µg/kg alone or combined with tramadol in lowering moderate to severe pain.

• Authors: Deying Xie, Fei Liu, Yunxia Zuo
• Journal: Journal of clinical pharmacology (J Clin Pharmacol) Vol. 63 Issue 6 Pg. 715-720 (06 2023) ISSN: 1552-4604 [Electronic] England
• PMID: 36762722 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.

Chemical References

• Sufentanil
• Tramadol
• Analgesics, Opioid
• Granisetron

Topics

• Male
• Humans
• Child
• Child, Preschool
• Sufentanil (adverse effects)
• Analgesia, Patient-Controlled (adverse effects)
• Tramadol
• Incidence
• Analgesics, Opioid (adverse effects)
• Pain, Postoperative (drug therapy)
• Postoperative Nausea and Vomiting (chemically induced, epidemiology)
• Granisetron
• Double-Blind Method