Abstract
Objectives: The trail investigated the effect of small dose sufentanil or fentanyl administrated before the end of surgery in reducing the incidence of emergence agitation after anesthesia with sevoflurane in preschool children undergoing ophthalmology surgery, and the incidence of emergence agitation of sevoflurane anesthesia. Methods: From September 2011 to January 2012 January, ninety ASA I-II children, aged from 3-7 years, undergoing ophthalmology surgery in West China Hospital, were randomly assigned to three groups to receive intravenous saline, sufentanil 0.1μg/kg or fentanyl 1μg/kg at 20 minutes before the end of the surgery. Children were scored by scoring system for emergence agitation (SSEA), Children’s and Infants’ Postoperative Pain Scale (CHIPPS) score. Results: The incidence of agitation was 30% in sufentanil group, 36.67% in fentanyl group, and 63.33% in control group. The incidence of sever agitation (SSEA score≥3) was 6.67% in sufentanil group, 23.37% in fentanyl group, and 36.67% in control group. The agitation and pain scores in sufentanil group and fentanyl group were better than those in control group (P<0.05). There was no difference among three groups about time to extubation. Conclusions: We conclude that the incidence of emergence agitation after sevoflurane anesthesia in children undergoing ophthalmology surgery is up to 63.33%. The single dose of sufentanil or fentanyl can reduce the emergence agitation in children anesthesized with sevoflurane, with no adverse effects. The effect of sufentanil is better than fentanyl.
Highlights
Sevoflurane is currently the most popular inhaled anesthetic in pediatric anesthesia
Li x7 and Li J8 reported sufentanil administrated during induction or before skin incision can decrease the incidence of emergence of agitation without delaying the recovery time
Just at about 20 minutes before the end of surgery, all patients were randomly assigned to receive 5 mL saline, sufentanil 0.1μg/Kg diluted in 5 mL of saline, or fentanyl 1μg/Kg diluted in 5 mL of saline injected
Summary
Sevoflurane is currently the most popular inhaled anesthetic in pediatric anesthesia. Sevoflurane has been reported to be associated with emergence agitation in pediatric patients, especially in preschool-aged children.[1,2] The reason for postoperative agitation or delirium is unclear. Factors such as pain, premedication drugs, rapid recovery, anxiety, and age have been reported. The effect of small dose sufentanil administered before the end of surgery has not been proven in previous studies This doubleblinded, placebo-controlled study was designed to evaluate sufentanil administered 20 minutes before the end of surgery to decrease agitation after sevoflurane anesthesia and investigate the incidence of emergence of agitation in a pediatric ophthalmology surgical population, comparing it with the fentanyl and saline
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