Intranasal sufentanil for postoperative pain control in lower abdominal pediatric surgery

Introduction: The most important role in postoperative pain management is still played by opioids administered through various modes. In the last few years, there had been an intensive search for alternative mode of opioids administration in pain management. The intranasal mode of opioids administration seems to be attractive alternative. Methods: Sixty boys (aged 0.5-6 yr); ASA physical status I, II were included in this prospective randomized controlled study. Five minutes before awake extubation, patients were allocated to receive intranasal sufentanil (0.7 µg/kg) or normal saline, using a double-blinded study design. Results: Satisfactory analgesia was achieved with sufentanil (p = 0.001) and it was effective during time, after 10 minutes with the least pain scores. Pain scores in 15, 20 and 25 minutes were similar in sufentanil group. None of patients had bradycardia, hypotension or SpO2 <95%. Conclusion: High bioavailability of sufentanil after intranasal administration due to direct entrance of the drug into the systemic circulation and avoidance of the hepatic first- pass effect makes sufentanil as an opioid with rapid onset and limited duration. As its minimal side effects, sufentanil is one of the best choices for postoperative pain control in children. We used 0.7 µg/kg of sufentanil and found satisfactory analgesia accompanying with least side effects.