Effects of remifentanil and remifentanil-alfentanil administration on emergence agitation after brief ophthalmic surgery in children

BMC Anesthesiology

Research Article

Jin Huan Chung¹  Seon Ju Kim¹  Soo Kyung Lee¹  Woon Suk Hwang¹  Yi Hwa Choi¹  Kyung Mi Kim²  Yi Seul Kim³ 

[1] Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro, 170 beon-gil, 431-796, Dongan-gu, Anyang, Republic of Korea;Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro, 170 beon-gil, 431-796, Dongan-gu, Anyang, Republic of Korea;Department of Anesthesiology and Pain Medicine, College of Medicine, Kangwon National University, 200-701, Chuncheon, Republic of Korea;Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, 02841, Seongbuk-gu, Seoul, 73 Inchon-ro, Republic of Korea;

关键词: Alfentanil;    Anesthesia recovery period;    Psychomotor agitation;    Remifentanil;    Sevoflurane;   

DOI  :  10.1186/s12871-016-0213-2

 received in 2015-10-21, accepted in 2016-07-21,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSevoflurane is commonly usedin pediatric anesthesia due to its non-irritating airway properties, and rapid induction and emergence. However, it is associated with emergence agitation (EA) in children. EA may cause injury to the child or damage to the surgical site and is a cause of stress to both caregivers and families. The efficacy of remifentanil and additional alfentanil on EA in the pediatric patients underwent ophthalmic surgery with sevofluraneanesthesiawas not well evaluated to date. This study was designed to compare the effects of remifentanil and remifentanil plus alfentanil on EA in children undergoing ophthalmic surgery with sevofluraneanesthesia.MethodsChildren (aged 3–9 years) undergoing ophthalmic surgery undersevoflurane anesthesia were randomly assigned to group S (sevoflurane alone), group R (sevofluraneandremifentanil infusion, 0.1 μg/kg/min), or group RA (sevoflurane withremifentanil infusion and intravenous injection of alfentanil 5 μg/kg 10 min before the end of surgery). Mean arterial pressure (MAP), heart rate (HR), and sevoflurane concentration were checked every 15 min after induction of anesthesia. The incidence of EA, time to extubation from discontinuation of sevoflurane inhalation, and time to discharge from the postanesthesia care unit was assessed.ResultsThe incidence of EA was significantly lower in groups R (32 %, 11/34; P = 0.01) and RA (31 %, 11/35; P = 0.008) than group S (64 %, 21/33). The time to extubation was prolonged in group RA (11.2 ± 2.3 min; P = 0.004 and P = 0.016) compared with groups S (9.2 ± 2.3 min) andR (9.5 ± 2.4 min). MAP and HR were similar in all three groups, apart from a reduction in HR at 45 min in groups R and RA. However, the sevoflurane concentration was lower in groups R and RA than group S (P < 0.001).ConclusionsThe administration of remifentanil to children undergoing ophthalmic surgery undersevoflurane anesthesia reduced the incidence of EA without clinically significant hemodynamic changes. However, the addition of alfentanil(5 μg/kg)10 min before the end of surgery provided no additional benefit compared withremifentanil alone.Trial registrationClinical trial number: NCT02486926, June.29.2015.

【 授权许可】

CC BY   
© Choi et al. 2016