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Transnasal butorphanol is effective for postoperative pain relief in children undergoing myringotomy

R E Bennie1, L A Boehringer, S F Dierdorf

  • 1Department of Anesthesia, Indiana University School of Medicine, Indianapolis 46202-5200, USA. rbennie@iupui.edu

Anesthesiology
|August 26, 1998
PubMed

Insights

Transnasal butorphanol at 25 mcg/kg effectively managed pain after bilateral myringotomy and tube placement (BMT) in children. This route offers an alternative for postoperative pain relief when IV access is not feasible.

Area of Science:

  • Anesthesiology
  • Pediatric Pain Management
  • Pharmacology

Background:

  • Over 70% of children need pain relief after bilateral myringotomy and tube placement (BMT).
  • Anesthesia for BMT often uses face masks, precluding intravenous catheter use for analgesia.
  • Transnasal butorphanol is a potential alternative for postoperative pain management in pediatric patients.

Purpose of the Study:

  • To evaluate the effectiveness of transnasal butorphanol for managing postoperative pain in children undergoing BMT.
  • To determine the optimal dosage of transnasal butorphanol for pediatric pain relief post-BMT.

Main Methods:

  • A double-blinded, placebo-controlled study involving 60 pediatric patients (ASA physical status 1 or 2, aged ≥6 months) undergoing elective BMT.
  • Randomization to receive transnasal placebo or butorphanol at doses of 5, 15, or 25 mcg/kg after anesthesia induction.
  • Postoperative pain assessment using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) at multiple time points.

Main Results:

  • The 25 mcg/kg transnasal butorphanol group showed significantly lower CHEOPS scores compared to the placebo group.
  • Significantly fewer children in the 25 mcg/kg group required rescue analgesia (1 vs. 8, P = 0.02).

Conclusions:

  • Transnasal butorphanol, administered at 25 mcg/kg post-anesthesia induction, provides effective postoperative pain relief for children undergoing BMT.
  • This non-intravenous route is a viable option for analgesia in pediatric BMT patients.
Abstract

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