Effects of fentanyl infusion on tracheal intubation and emergence agitation in preschool children anaesthetized with sevoflurane
- PMID: 20627877
- DOI: 10.1093/bja/aeq168
Effects of fentanyl infusion on tracheal intubation and emergence agitation in preschool children anaesthetized with sevoflurane
Abstract
Background: Sevoflurane can be used as a sole agent for intubation in children, but studies have suggested that it is associated with emergence agitation. Fentanyl infusions can be used both to facilitate intubation and decrease emergence agitation. We investigated the effects of fentanyl on conditions at intubation and on emergence from sevoflurane anaesthesia without confounding nitrous oxide or premedication.
Methods: IRB approval and informed consent were obtained. Subjects comprised 150 ASA physical status I or II (age, 2-6 yr). Anaesthesia was induced with sevoflurane in oxygen and maintained using a predetermined concentration of sevoflurane. Subjects were randomly allocated to receive one of three doses of fentanyl: vehicle only (control group), a bolus dose of 1 microg kg(-1) followed by a continuous infusion of 0.5 microg kg(-1) h(-1) (F1 group), or a bolus dose of 2 microg kg(-1) followed by a continuous infusion of 1 microg kg(-1) h(-1) (F2 group). Sevoflurane minimum alveolar concentration for tracheal intubation (MAC(TI)) and emergence agitation score were assessed.
Results: MAC(TI) values were 2.49%, 1.61%, and 1.16% in control, F1, and F2 groups, respectively (P<0.05). Agitation scores were 11.5, 7.0, and 2.6 in control, F1, and F2 groups, respectively (P<0.05).
Conclusions: Fentanyl infusion consisting of a bolus dose of 2 microg kg(-1) followed by a continuous infusion of 1 microg kg(-1) h(-1) facilitates tracheal intubation and smooth emergence in children anaesthetized using sevoflurane.
Clinical trial registration: this study was started in 2000 and was finished in 2008. We had no registration number. IRB approval was obtained.
Similar articles
-
Effects of sevoflurane versus other general anaesthesia on emergence agitation in children.Cochrane Database Syst Rev. 2014 Sep 12;2014(9):CD007084. doi: 10.1002/14651858.CD007084.pub2. Cochrane Database Syst Rev. 2014. PMID: 25212274 Free PMC article. Review.
-
Effects of dexmedetomidine on sevoflurane requirement for 50% excellent tracheal intubation in children: a randomized, double-blind comparison.Paediatr Anaesth. 2014 Sep;24(9):987-93. doi: 10.1111/pan.12430. Epub 2014 May 14. Paediatr Anaesth. 2014. PMID: 24823715 Review.
-
Combination effect of low dose fentanyl and propofol on emergence agitation in children following sevoflurane anesthesia.Saudi Med J. 2009 Apr;30(4):500-3. Saudi Med J. 2009. PMID: 19370275 Clinical Trial.
-
Effects of fentanyl on the incidence of emergence agitation in children receiving desflurane or sevoflurane anaesthesia.Eur J Anaesthesiol. 2004 Jul;21(7):538-42. doi: 10.1017/s0265021504007069. Eur J Anaesthesiol. 2004. PMID: 15318465 Clinical Trial.
-
Comparison of sevoflurane and halothane anesthesia in children undergoing outpatient ear, nose, and throat surgery.J Clin Anesth. 1995 Aug;7(5):398-402. doi: 10.1016/0952-8180(95)00071-o. J Clin Anesth. 1995. PMID: 7576676 Clinical Trial.
Cited by
-
A Comparative Study between Propofol-fentanyl versus Propofol-suxamethonium for Ease of Endotracheal Intubation in Children.J West Afr Coll Surg. 2023 Jan-Mar;13(1):55-59. doi: 10.4103/jwas.jwas_229_22. Epub 2023 Jan 18. J West Afr Coll Surg. 2023. PMID: 36923820 Free PMC article.
-
Pre-operative administration of butorphanol mitigates emergence agitation in patients undergoing functional endoscopic sinus surgery: A randomized controlled clinical trial.Front Psychiatry. 2023 Jan 17;13:1090149. doi: 10.3389/fpsyt.2022.1090149. eCollection 2022. Front Psychiatry. 2023. PMID: 36733413 Free PMC article.
-
The Effect of Alfentanil on Emergence Delirium Following General Anesthesia in Children: A Randomized Clinical Trial.Paediatr Drugs. 2022 Jul;24(4):413-421. doi: 10.1007/s40272-022-00510-5. Epub 2022 Jun 13. Paediatr Drugs. 2022. PMID: 35698001 Free PMC article. Clinical Trial.
-
Comparative Effects of Total Intravenous Anesthesia with Propofol and Remifentanil Versus Inhalational Sevoflurane with Dexmedetomidine on Emergence Delirium in Children Undergoing Strabismus Surgery.Anesth Pain Med. 2020 Dec 20;11(1):e109048. doi: 10.5812/aapm.109048. eCollection 2021 Feb. Anesth Pain Med. 2020. PMID: 34221936 Free PMC article.
-
Emergence agitation: current knowledge and unresolved questions.Korean J Anesthesiol. 2020 Dec;73(6):471-485. doi: 10.4097/kja.20097. Epub 2020 Mar 25. Korean J Anesthesiol. 2020. PMID: 32209961 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous