Effect of route of buprenorphine on recovery and postoperative analgesic requirement in paediatric patients

Background: We compared the effects of extradural with intravenous (i.v.) buprenorphine on postoperative pain and recovery characteristics. Methods: Thirty patients, aged 11-13 years, who were undergoing inguinal hernia repair with or without orchidopexy, were randomly allocated to receive either caudal 0.5% bupivacaine alone (group A) or were additionally given i.v. buprenorphine 2.5 μg·kg^-1 (group B) or caudal buprenorphine in the same dose (group C). Patients were followed for 8 h after the end of surgery. Results: All patients remained haemodynamically stable during the study period and no clinical respiratory depression was seen. Nausea, vomiting, urinary retention and pruritus were more common in the extradural buprenorphine group. Three patients in group A, five in group B and eight in group C did not require any additional analgesia during the study period. The incidence of vomiting was 20%, 50% and 80% in groups A, B and C, respectively. Four patients in group C had urinary retention compared with one each in the other two groups. Conclusions: Administration of buprenorphine resulted in a higher incidence of side-effects.