Intranasal fentanyl provides adequate postoperative analgesia in pediatric patients.

Purpose: To evaluate intranasally administered fentanyl for postoperative analgesia in pediatric patients.

Methods: Thirty-two children aged four to eight years, ASA physical status I and II were included in this prospective randomized controlled study. In the postoperative care unit, patients were allocated to receive fentanyl, using a double-blind study design, either intranasally (Group I) or intravenously (Group II) in small titrated doses until they became pain free or side effects appeared which prohibited continuation of the drug.

Results: Satisfactory analgesia was achieved in both groups, though the required drug dosage was higher in the intranasal group (1.43 +/- 0.39 microg.kg(-1)). Onset of analgesia tended to be slower via the intranasal route compared to the iv route (13 +/- 4.5 vs 8.3 +/- 3.08 min; P=not significant). Side effects observed in this series were within an acceptable range and similar for both modalities.

Conclusion: The intranasal route provides a good alternative for administration of fentanyl in pediatric surgical patients.