A comparison of remifentanil in paediatric and adult anaesthesia

Background: Anaesthesia for children and adults are different in many aspects,one of them beeing dosage of anaesthestics.We decided to compare the doses of remifentanil infusion required for adults and children undergoing procedures in oral and maxillofacial surgery, as well as ear,throat and nose surgery. Material/Methods: 18 paediatric and 21 adult patients were anaesthetised with infusion of remifentanil 0.5 mcg/kg/min,after a bolus of 1 mcg/kg given during induction.Other drugs:thiopentone,atracurium and midazolam were administered according to the typical rules of administration in children or adult population.Total doses of remifentanil in mcg/kg/min were calculated and compared.Postanaesthesia recovery profile and requirement for postoperative analgesia were also compared. Results: No significant difference was found between doses:0.67 and 0.57 mcg kg/min for children and adults respectively.There was no difference in recovery profile,but higher level of nausea and vomiting (55%vs.28.6%)and postoperative pain score (0.89 vs. 0.43)was observed in children. This may be explained by lower tolerance of nausea and pain in this group of patients.Conclusions: There is no important difference in dosage of remifentanil calculated on continuous infusion rate between children and adults.

Keywords: opioids:remifentanil, pharmacology:adults, children:general anaesthesia, intravenous anaesthesia