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

Published online by Cambridge University Press:  23 December 2004

S. Demirbilek ,
T. Togal ,
M. Cicek ,
U. Aslan ,
E. Sizanli  and
M. O. Ersoy
S. Demirbilek
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
T. Togal
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
M. Cicek
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
U. Aslan
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
E. Sizanli
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
M. O. Ersoy
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
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Extract

Summary

Background and objective: In children, emergence agitation frequently complicates sevoflurane and desflurane anaesthesia. The effect of intravenous fentanyl 2.5 μg 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 1 and 3 received physiological saline solution, whereas patients in Groups 2 and 4 received intravenous fentanyl 2.5 μg kg−1 during induction. Anaesthesia was maintained with sevoflurane in Groups 1 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 μg kg−1 did not provide any clinically significant benefit on emergence agitation in children who receive sevoflurane or desflurane anaesthesia.

Keywords

ANAESTHETICS, INHALATION, desflurane, sevofluraneCHILDREN, midazolam, premedicationCOMPLICATIONS, emergence agitation
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 7 , July 2004 , pp. 538 - 542
Copyright
2004 European Society of Anaesthesiology

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