Comparing the Time of Extubation, Postoperative Apnea Incidence, and the Quality of Perioperative Analgesia in Infants Scheduled for Pyloromyotomy- Intravenous Bolus Fentanyl vs. Rectal Acetaminophen

Abstract

In this study, we compared the effect of intravenous fentanyl blouse with acetaminophen rectal during extubation, the incidence of postoperative apnea and the quality of analgesia in the infants under pyloromyotomy. Materials and Methods: In a randomized controlled double-blind trial, 24 children with hypertrophic pyloric stenosis were equally divided into either fentanyl or acetaminophen groups. In the fentanyl group as an analgesic, fentanyl (1 µg/kg) was administered with midazolam IV and in the acetaminophen group, rectal acetaminophen was administered 40 mg/kg (20-30 minutes prior to midazolam injection) in both the interval between anesthesia and extubation gases, recovery clearance time, and the number of apnea occurred during the post-extubation period were recorded. Patients in both groups after transfer to the department had a pain score of 4 (based on the protocol of FLACC) received acetaminophen at a dose of 15 mg/kg. In both groups, the FLACC score and the amount of acetaminophen used for analgesia in the post-operative period were recorded. Results: In the study, the patients were studied for three periods of anesthesia from midazolam administration to cessation of sulfurane (T1; operative time), the duration of recovery to extubation (T2; extubation time) and the duration from recovery to discharge (T3; recovery time). There was no significant difference between the two groups (p> 0.05); however, in comparison with the two groups, extubation time (T1) and recovery time (T2) was lower in the acetaminophen group than in the fentanyl group. Comparing the FLACC Score in terms of postoperative pain score in the patients in the recovery and discharge time at first, second and fourth hours after discharge and recovery, there was no significant difference between the two groups (p> 0.05). In all cases, the rate of postoperative pain in the fentanyl group was higher than the acetaminophen group.