The Effect of Combined Use of Remifentanil on Postoperative Recovery Time and Emergence Agitation during Sevoflurane Anesthesia in Children

Abstract

Background: Sevoflurane anesthesia may show emergence agitation and delirium in children, compared to other inhalation agents. Therefore, we studied the effect of low dose sevoflurane on recovery time and emergence agitation in children. Methods: We studied 50 patients who were planned for surgery under general anesthesia, aged between 2 and 8 years. They were randomly divided into two groups. Patients of group S were anesthetized with sevoflurane 2.5-3 vol%, whereas those of group R were given sevoflurane 1.2-1.5 vol% and continuous intravenous infusion of remifentanil 0.1-0.2μg/kg/min. All patients received N2O：O2 50：50 during maintenance of anesthesia. After the surgery, the anesthesiologist recorded recovery time and determined agitation score using 5-point scoring scale in both groups. Agitation score, incidence of emergence agitation and recovery time were compared with each other between the two groups. Results: The agitation scores were 2.72 ± 0.98 and 2.64 ± 0.95 in S and R groups, respectively, showing statistical insignificance. The incidence of emergence agitation score 4 or 5 was not significantly different, either. The recovery time was statistically shorter in R group (P ＜ 0.05). Conclusions: Compared with sevoflurane inhalation anesthesia alone, the use of sevoflurane and remifentanil in combination provided shorter recovery time, but no effect on emergence agitation. (Korean J Anesthesiol 2007; 52: 675～80)