Remifentanil Tapering and Post-adenotonsillectomy Pain in Children
Status:
Recruiting
Trial end date:
2022-07-01
Target enrollment:
Participant gender:
Summary
Tonsillectomy is the commonest operation of childhood and results in considerable pain.
Remifentanil is a potent, ultra short acting opioid with a long- established safety record in
paediatric anaesthesia that is used to provide intraoperative analgesia.
There is evidence from adult studies that remifentanil increases postoperative pain, although
this may be ablated if propofol (rather than inhalational anaesthesia) is used or if the
remifentanil is tapered rather than abruptly discontinued at the end of surgery.
The analgesic effect of gradual withdrawal of remifentanil at the end of surgery has not been
studied in children and may have significant clinical implications.
The primary measure of efficacy will be the dose of fentanyl rescue analgesia in the
peri-operative period (1 mcg.kg-1 bolus for >20% increase in pulse, blood pressure or
movement intraoperatively or a FLACC(Face, Legs, Arms, Cry, Consolablity) score of >5 in
recovery).