The effects of low-dose fentanyl on emergence agitation and quality of life in patients with moderate developmental disabilities.
OBJECTIVE
To analyze whether emergence agitation could be reduced by using a low dosage of fentanyl without causing an increase in postoperative adverse effects and/or affecting the patient's quality of life after discharge.


METHODS
Randomized, controlled crossover trial.


METHODS
University medical center.


METHODS
One hundred ten ASA physical status I and II ambulatory patients with moderate developmental disabilities who received anesthesia for dental care.


METHODS
During their first visit, patients were randomly treated either with a placebo or a 1- to 1.5-microg/kg dose of fentanyl before inserting a reinforced laryngeal mask airway and treated with the remaining method during their second visit 6 to 12 months later.


METHODS
Measured variables included anesthetic and emergence period, the occurrence of emergence agitation, and postanesthetic adverse effects such as nausea and vomiting. After discharge, the patient's quality of life was evaluated based on disturbances in daily activity, eating habit, and sleeping behavior. Results were analyzed by Student t test and McNemar test (P < 0.05).


RESULTS
Between the two treatments, there was a significant difference in the frequency of emergence agitation (P = 0.04) but no postoperative adverse effects such as postoperative nausea and vomiting. We also found no significant disturbances in the patient's quality of life according to daily activity, eating habits, or sleeping behavior.


CONCLUSIONS
Emergence agitation may be reduced by using 1 to 1.5 microg/kg of fentanyl during induction while maintaining anesthesia by sevoflurane in patients with moderate developmental disabilities undergoing dental care, without causing an increase in postoperative adverse effects and affecting the patient's life quality after discharge.
Hung
Wei-Te
WT
Department of Anesthesiology, School of Medicine, Chung Shan Medical University, Taichung 403, Taiwan. cshy029@csh.org.tw
Chen
Ching-Chi
CC
Liou
Cher-Ming
CM
Tsai
Wei-Yann
WY
D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D003729:Dental Care; D002658:Developmental Disabilities / Q000150:complications / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000139:chemically induced / Q000523:psychology*; D020250:Postoperative Nausea and Vomiting / Q000150:complications / Q000523:psychology; D011595:Psychomotor Agitation / Q000517:prevention & control*; D011788:Quality of Life / Q000523:psychology*
D009294:Narcotics; D005283:Fentanyl