Effects of fentanyl on the incidence of emergence agitation in children receiving desflurane or sevoflurane anaesthesia

被引:58
作者
Demirbilek, S [1 ]
Togal, T [1 ]
Cicek, M [1 ]
Aslan, U [1 ]
Sizanli, E [1 ]
Ersoy, MO [1 ]
机构
[1] Inonu Univ, Sch Med, Dept Anaesthesiol, Malatya, Turkey
关键词
anaesthetics; inhalation; desflurane; sevoflurane; children; midazolam; premedication; complications; emergence agitation;
D O I
10.1017/S0265021504007069
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and objective: In children, emergence agitation frequently complicates sevoflurane and desflurane anaesthesia. The effect of intravenous fentanyl 2.5 mug kg(-1) was examined on the incidence of emergence agitation in children who received desflurane or sevoflurane after midazolam premedication and intravenous thiopental induction. Methods: One hundred and twenty children (2-7 yr) undergoing adenoidectomy or tonsillectomy, or both, were studied. All children were premedicated orally with midazolam 0.5 mg kg(-1). After intravenous induction with thiopental and atracurium to facilitate endotracheal intubation, patients were randomly assigned to one of four groups: Patients in Groups I and 3 received physiological saline solution, whereas patients in Groups 2 and 4 received intravenous fentanyl 2.5 mug kg(-1) during induction. Anaesthesia was maintained with sevoflurane in Groups I and 2 and with desflurane in Groups 3 and 4. After discontinuation of the volatile anaesthetic, the times to tracheal extubation and response to verbal stimuli (emergence time), and emergence behaviours were recorded. Results: The time to tracheal extubation was significantly shorter in Groups 3 (5.2 +/- 1.7 min) and 4 (6.4 +/- 2.1 min) than in Groups 1 (8.1 +/- 2.1 min) (P = 0.0001 and 0.006, respectively) and 2 (8.8 +/- 1.9 min) (P = 0.0001). The emergence time was significantly shorter in Group 3 (10.0 +/- 3.9 min) than in Groups 1 (13.8 +/- 4.9 min) (P = 0.017) and 2 (14.9 +/- 4.1 min) (P = 0.003). The incidence rate of severe agitation was 13% in Groups 1 and 3, and 7 and 10% in Groups 2 and 4, respectively (P > 0.05). Conclusions: After midazolam premedication and intravenous induction of anaesthesia with thiopental, administration of intravenous fentanyl 2.5 mug kg(-1) did not provide any clinically significant benefit on emergence agitation in children who receive sevoflurane or desflurane anaesthesia.
引用
收藏
页码:538 / 542
页数:5
相关论文
共 28 条
[1]   Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys [J].
Aono, J ;
Ueda, W ;
Mamiya, K ;
Takimoto, E ;
Manabe, M .
ANESTHESIOLOGY, 1997, 87 (06) :1298-1300
[2]   Preoperative anxiety is associated with a high incidence of problematic behavior on emergence after halothane anesthesia in boys [J].
Aono, J ;
Mamiya, K ;
Manabe, M .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1999, 43 (05) :542-544
[3]   MIDAZOLAM ACTS SYNERGISTICALLY WITH FENTANYL FOR INDUCTION OF ANESTHESIA [J].
BENSHLOMO, I ;
ABDELKHALIM, H ;
EZRY, J ;
ZOHAR, S ;
TVERSKOY, M .
BRITISH JOURNAL OF ANAESTHESIA, 1990, 64 (01) :45-47
[4]   The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children [J].
Cohen, IT ;
Finkel, JC ;
Hannallah, RS ;
Hummer, KA ;
Patel, KM .
ANESTHESIA AND ANALGESIA, 2002, 94 (05) :1178-1181
[5]  
Cohen IT, 2001, ANESTH ANALG, V93, P88
[6]   Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol [J].
Cohen, IT ;
Finkel, JC ;
Hannallah, RS ;
Hummer, KA ;
Patel, KM .
PAEDIATRIC ANAESTHESIA, 2003, 13 (01) :63-67
[7]   Emergence agitation in paediatric patients after sevoflurane anaesthesia and no surgery: a comparison with halothane [J].
Cravero, J ;
Surgenor, S ;
Whalen, K .
PAEDIATRIC ANAESTHESIA, 2000, 10 (04) :419-424
[8]   RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS HALOTHANE FOR MAINTENANCE OF ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS [J].
DAVIS, PJ ;
COHEN, IT ;
MCGOWAN, FX ;
LATTA, K .
ANESTHESIOLOGY, 1994, 80 (02) :298-302
[9]  
Finkel JC, 2001, ANESTH ANALG, V92, P1164
[10]   Total intravenous anaesthesia with propofol and remifentanil in paediatric patients: a comparison with a desflurane-nitrous oxide inhalation anaesthesia [J].
Grundman, U ;
Uth, M ;
Eichner, A ;
Wilhelm, W ;
Larsen, R .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1998, 42 (07) :845-850