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Geographic differences in perioperative opioid administration in children
Jennifer A Rabbitts1, Cornelius B Groenewald, Jukka Räsänen
1Department 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
Paediatric Anaesthesia
|February 14, 2012
Summary
Geographic location impacts pediatric opioid use during surgery. Children in Central and South America received significantly less intraoperative fentanyl for cleft repair compared to those in Africa and India.
Area of Science:
- Pediatric Anesthesiology
- Global Health
- Pharmacology
Background:
- Previous studies noted ethnic disparities in pediatric perioperative opioid administration within the USA.
- The existence of geographic variations in pediatric perioperative opioid use remained unexplored.
Purpose of the Study:
- To determine if geographic location influences perioperative opioid administration in pediatric patients.
- Specifically, to compare perioperative fentanyl use in children undergoing cleft lip and palate surgery across three distinct geographic regions.
Main Methods:
- Retrospective review of medical records for ASA I children undergoing standardized general anesthesia.
- Data collected during international mission trips to Africa, India, and Central/South America between January 2010 and April 2011.
- Comparison of perioperative fentanyl administration across the three geographic locations.
Main Results:
- Data analyzed from 79 children in Africa, 76 in India, and 153 in Central/South America.
- Children in Central/South America received less than half the intraoperative fentanyl dose compared to children in Africa (4.1 mcg·kg⁻¹) and India (4.3 mcg·kg⁻¹).
- Postoperative fentanyl administration was consistent across all groups.
Conclusions:
- Significant geographic disparities exist in intraoperative fentanyl administration for pediatric cleft surgery.
- Children in Central and South America received substantially lower intraoperative opioid doses.
- Further investigation is required to understand the reasons behind these observed geographic differences.
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