Comparison of two different doses of nalbuphine for postoperative tonsillectomy pain in children

Aim: tonsillectomy has a high incidence of postoperative pain. we studied 0.25 mg kg-1 nalbuphine at the time of induction of general anaesthesia to assess the effectiveness of analgesia in postoperative period and compare it to 0.1 mg kg-1. study design: comparative interventional. place and duration of study: this study was conducted at the paediatric ent department of the children hospital and the institute of child health lahore from 2007 to 2010. methodology: sixty asa physical status one patients,aged 5-12 years scheduled for tonsillectomy were included in this study. patients were divided randomly into two groups of 30 each. group a received 0.25mg kg-1 nalbuphine and group b received 0.1 mg kg-1 nalbuphine at induction of anaesthesia. general anaesthesia was induced and maintained with standard technique. all patients were monitored throughout the surgery and postoperatively in recovery room. the children's hospital of eastern ontario pain scale (cheops) was used to evaluate pain objectively in post op period. results: there was significant reduced requirement of analgesia in immediate recovery room in group a. cheops score was 4±0.18 (p value=0.001). side effects especially ponv were similar in two groups. mild sedation was noted in 73% in group a and 76% in group b. conclusion: we conclude that nalbuphine in therapeutic doses of 0.25mg kg-1 at the time of induction of general anaesthesia is effective dose to keep the pain free wake up and recovery room stay for children of 5 to 12 years for tonsillectomy without the comorbidities as osas (obstructive sleep apnea syndrome),airways anomalies. it provides child centered approach to post operative analgesia for tonsillectomy without significant side effects.