366 USE OF BUTORPHANOL FOR POST OPERATIVE PAIN IN CHILDREN

Abstract

Butorphanol (B), a new synthetic agonist-antagonist type analgesic, was evaluated in 34 patients aged 4-12 years requiring a parenteral medication for relief of pain following elective surgical procedures. B was administered IM when, in the estimate of the patient or the recovery room staff, an analgesic was required. Doses of B ranged from 0.01 mg/kg to 0.02 mg/kg, with most patients receiving 0.015 mg/kg. Scores of pain intensity (0-3) and relief (0-4) were done prior to dosing and at hourly intervals for six hours following the dose, or until additional medication was required. Surgery included orthopedic (12), abdominal (5), non-cardiac thoracic (3), genitourinary (11) and miscellaneous (2) procedures. There were 19 male and 15 female patients. 16/34 patients continued to experience good pain relief at the end of the six hour observation period. The mean length of time to remedication was 5.0 hr. with a 6 hr. maximum given. The range was 2-6 hr. At any given dose, pain relief tended to be better and more prolonged in the younger patients. This may derive from the increased sedation seen with B in the younger children. There was no significant difference between the three doses used in degree or duration of analgesic effect. Except for one patient who experienced transient urinary retention, sedation was the only significant side effect seen. This is the first reported dose ranging study of pain therapy in children. B, at a dose of 0.01-0.02 mg/kg, provided good relief of post-operative pain in children.