Iv perioperative ketoprofen in small children during adenoidectomy

We have investigated the analgesic and opioid sparing effect of perioperative i.v. ketoprofen in a randomized, double-blind, placebo-controlled, parallel group study in 164 children, aged 1-7 yr, after adenoidectomy. A standard anaesthetic method was used and all children received fentanyl 1 mu g kg(-1) i.v. during induction. Children in the ketoprofen group received ketoprofen 1 mg kg(-1) i.v. after induction of anaesthesia followed by an infusion of ketoprofen 1 mg kg(-1) over 2 h. Children in the placebo group received 0.9% saline. All children received fentanyl 1 mu g kg(-1) i.v. as rescue analgesia. In the ketoprofen group less children required postoperative fentanyl (64% vs 77%, P = 0.006) and the total number of fentanyl doses was smaller compared with the placebo group (mean 1.0 (SD 1.1) (95% confidence intervals (Cl) 0.8-1.3) vs 1.5 [1.1] (95% Cl 1.2-1.7), P = 0.012). Worst pain observed in the postanaesthesia care unit was also lower in the ketoprofen group both at rest (P = 0.028) and during swallowing (P = 0.001). There were no difference in the number of adverse reactions between the groups. No serious adverse reactions occurred.