Fentanyl reduces desflurane-induced airway irritability following thiopental administration in children.
BACKGROUND
Airway irritation is a major drawback of desflurane anesthesia. This study was designed to evaluate the effect of intravenous fentanyl given before thiopental induction on airway irritation caused by a stepwise increase in desflurane in children.


METHODS
Eighty children (2-8 years) were enrolled in a randomized, double-blind study. Forty received saline and 40 received 2 microg/kg of fentanyl intravenously; this was followed by thiopental sodium 5 mg/kg in both groups. Patients were assistant-ventilated with desflurane 1%, which was then increased by 1% every six breaths up to 10%. During this period, cough, secretion, excitation and apnea were graded and the desflurane concentration at which airway irritation symptoms first occurred was recorded. The results were analyzed using Pearson's chi-squared test.


RESULTS
The incidence of typical airway irritation events was lower with fentanyl than with saline (cough, 2.5% vs. 42.5%; secretion, 27.5% vs. 82.5%; excitation, 10% vs. 82.5%; apnea, 20% vs. 65%; P < 0.05). The mean expired desflurane concentration at which the first airway irritation symptom occurred was greater with fentanyl than with saline (7.3% vs. 5.5%, P < 0.05).


CONCLUSIONS
Intravenous fentanyl in children reduces airway complications caused by desflurane.
Lee
J
J
Department of Anesthesiology, Seoul National University, College of Medicine, Seoul, South Korea.
Oh
Y
Y
Kim
C
C
Kim
S
S
Park
H
H
Kim
H
H
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001049:Apnea / Q000139:chemically induced / Q000188:drug therapy; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000139:chemically induced / Q000188:drug therapy; D000077335:Desflurane; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007275:Injections, Intravenous; D007509:Irritants; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D009093:Mucus / Q000378:metabolism; D013874:Thiopental / Q000009:adverse effects*
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D007509:Irritants; D000077335:Desflurane; D007530:Isoflurane; D013874:Thiopental; D005283:Fentanyl