title: The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children.
abstract: Desflurane and sevoflurane anesthesia are associated with emergence agitation in children. In this study, we examined the effect of a single intraoperative dose of fentanyl on emergence characteristics in children undergoing adenoidectomy. One hundred children, 2-7 yr old, were randomly assigned to receive desflurane or sevoflurane for maintenance of general anesthesia after an inhaled induction with sevoflurane and a 2.5 microg/kg dose of fentanyl. An observer blind-ed to the anesthetic technique assessed the times to achieve emergence, extubation and recovery criteria, as well as emergence behaviors. The results showed a similar incidence of severe emergence agitation after general anesthesia with desflurane (24%) and sevoflurane (18%). Times to achieve extubation and postanesthesia care unit discharge criteria were shorter with desflurane than with sevoflurane. With this technique, desflurane allows for a more rapid emergence and recovery than sevoflurane. In children receiving desflurane or sevoflurane, the concurrent use of fentanyl in a dose of 2.5 microg/kg results in a small incidence of emergence agitation.
  
  
  CONCLUSIONS
  The concurrent use of fentanyl in a dose of 2.5 microg/kg in children receiving desflurane or sevoflurane results in a low incidence of emergence agitation. Desflurane allows for a more rapid emergence and recovery than sevoflurane.
authors.affiliation: Department of Anesthesiology, Children's National Medical Center, Washington, DC 20010, USA. icohen@cnmc.org
authors.forename: Ira Todd
authors.initials: IT
authors.lastname: Cohen
authors.forename: Julia C
authors.initials: JC
authors.lastname: Finkel
authors.forename: Raafat S
authors.initials: RS
authors.lastname: Hannallah
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Hummer
authors.forename: Kantilal M
authors.initials: KM
authors.lastname: Patel
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D000077335:Desflurane; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007530:Isoflurane / Q000009:adverse effects* / Q000031:analogs & derivatives; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy; D011229:Preanesthetic Medication; D011595:Psychomotor Agitation / Q000517:prevention & control*; D000077149:Sevoflurane
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl