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Related Experiment Video

Updated: Jun 19, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

A Triple-Blinded, Randomized, Controlled Trial Comparing Hydromorphone vs. Fentanyl for Children Undergoing

Gregory C Miller1, Alan J Hifko2, Julia K Lieu2

  • 1Division of Pediatric Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, USA.

Paediatric Anaesthesia
|June 18, 2026
PubMed
Summary

Hydromorphone reduced the need for rescue opioids after pediatric tonsillectomy compared to fentanyl. This finding suggests hydromorphone offers better pain management for children undergoing this common surgery.

Keywords:
fentanylhydromorphoneopioid analgesicspediatric anesthesiapostoperative paintonsillectomy

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Last Updated: Jun 19, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Outcomes

Background:

  • Tonsillectomy is a common pediatric surgery with limited evidence guiding intraoperative opioid selection.
  • Children undergoing tonsillectomy are at increased risk for respiratory complications.
  • This study aimed to compare hydromorphone and fentanyl for intraoperative analgesia.

Purpose of the Study:

  • To test if hydromorphone reduces the need for postoperative rescue opioids compared to fentanyl in pediatric tonsillectomy patients.
  • To evaluate pain scores, oxygen saturation, nausea, and recovery time.
  • To assess the safety profile of intraoperative hydromorphone versus fentanyl.

Main Methods:

  • A triple-blind, randomized controlled trial was conducted.
  • Pediatric patients (2-15 years) received either hydromorphone (10 mcg/kg) or fentanyl (1 mcg/kg) intraoperatively.
  • The primary outcome was the requirement for rescue intravenous opioid analgesia post-extubation.

Main Results:

  • Fewer children receiving hydromorphone required rescue opioids (53%) compared to fentanyl (73%).
  • Hydromorphone group showed lower postoperative pain scores and morphine milligram equivalents.
  • Adverse event rates were similar between the hydromorphone and fentanyl groups.

Conclusions:

  • Intraoperative hydromorphone improved analgesia in the recovery room compared to fentanyl for pediatric tonsillectomy.
  • Hydromorphone may be a preferred opioid for intraoperative use in this patient population.
  • Further research can explore long-term pain management strategies post-tonsillectomy.