Development of Acute Opioid Tolerance During Infusion of Remifentanil for Pediatric Scoliosis Surgery

We tested the hypothesis that continuous intraopera-tive infusion of remifentanil is associated with the de-velopment of clinically relevant acute opioid tolerance in adolescents undergoing scoliosis surgery. Thirty ad-olescents were randomly assigned to receive an intra-operative analgesic regimen consisting of continuous remifentanil infusion or intermittent morphine alone. Postoperative analgesic consumption was assessed with a patient-controlled analgesia device that was used to self-administer morphine. Cumulative postop-erative morphine consumption, pain scores, and seda-tion scores were recorded by a blinded investigator ev-ery hour for the first 4 h postoperatively and then every 4 h for a total of 24 h. Cumulative morphine consump-tion in the remifentanil group was significantly mor