A Triple-Blinded, Randomized, Controlled Trial Comparing Hydromorphone vs. Fentanyl for Children Undergoing Tonsillectomy.
Paediatr AnaesthJun 18, 2026 (epub)
Gregory C Miller, Alan J Hifko, Julia K Lieu et al.
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In 30 seconds
This triple-blind, randomized controlled trial compared hydromorphone and fentanyl in 180 children aged 2-15 undergoing tonsillectomy. The study found that 53% of those receiving hydromorphone required postoperative rescue opioids compared to 73% of those receiving fentanyl, a significant difference of 20.0 percentage points (p=0.005).
Key findings
- 53% of children receiving hydromorphone required rescue opioids versus 73% for fentanyl (p=0.005).
- Hydromorphone group had lower mean pain scores in the first 15 minutes postoperatively.
- Children receiving hydromorphone used lower median morphine milligram equivalents.
Why it matters
The choice of intraoperative opioid can significantly impact postoperative pain management and opioid requirements in pediatric patients, particularly in a high-risk surgical population.