BUTORPHANOL - AN OPIOID FOR DAY-CARE PEDIATRIC-SURGERY

The purpose of this study was to compare the side effects and efficacy of equianalgesic doses of morphine (M) and butorphanol (B) in childre n undergoing similar surgical procedures associated with moderate post operative pain. We studied 156 healthy children aged 1.5-13 yr Mho und erwent elective inguinal herniorrhaphy or orchidopexy. After induction of anaesthesia subjects were given 150 mu g . kg(-1) M or 30 mu g . k g(-1) B following a randomized, stratified, blocked and double-blind d esign. A standardized anaesthetic was administered which included 1.5% halothane, vecuronium dropericiol and mechanical ventilation. The pos tsurgical four-hour follow-up included assessment of pain, vomiting an d respiratory depression. Pain was assessed with mCHEOPS and analgesic s were administered when indicated in the recovery room. Each opioid w as administered to a group of 78 patients. Within each group, 25 subje cts had an iv induction, 21 children had an orchidopexy and 57 had ing uinal hernia repairs. The groups were similar with respect to age, wei ght, and length of surgery. The choice of opioid did nor affect recove ry limes from anaesthesia. Analgesic requirements were similar among t he groups Ten minutes after arrival in the recovery room the B-subject s had a lower pain score than the M-patients. Postoperative vomiting w as less among the B-subjects: 14% vs 28%, P = 0.03. Two M-patients req uired an unscheduled admission to hospital because of vomiting. It is concluded that butorphanol has few advantages over morphine in the pop ulation studied.