Combination effect of low dose fentanyl and propofol on emergence agitation in children following sevoflurane anesthesia.
OBJECTIVE
To investigate the combination effect of low dose fentanyl and subhypnotic dose of propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure.


METHODS
After ethical approval, a prospective, randomized, clinical study was performed in Saad Specialist Hospital, Al-Khobar, Kingdom of Saudi Arabia in 2007-2008. One hundred and twenty children in physical status of I according to the American Society of Anesthesiologists, aged 2-6 years, scheduled for adentonsillectomy under general anesthesia were allocated into 3 groups randomly. Anesthesia was induced and maintained by sevoflurane in all groups. Children received 0.1 ml.kg-1 normal saline at the end of surgery in group C (n=40), 1.5 mcg.kg-1 fentanyl during induction, and 0.1 ml.kg-1 normal saline at the end of surgery in group F (n=40), and 1.5 mcg.kg-1 fentanyl during induction and 1 mg.kg-1 propofol at the end of surgery in group FP (n=40). Postoperative agitation was recorded, if any, for the first postoperative hour.


RESULTS
Three groups were comparable with regard to demographic data. Twenty-one patients (53%) in the control group, 14 patients (35%) in group F and 7 (18%) patients in group FP experienced postoperative agitation.


CONCLUSIONS
The combination of low dose fentanyl before surgery and propofol at the end of surgery decreases the incidence and level of emergence agitation in children after adenotonsillectomy procedure under sevoflurane anesthesia.
Department of Anesthesiology, Saad Specialist Hospital, Al-Khobar, Kingdom of Saudi Arabia.
Hassan S
HS
Bakhamees
Arzu
A
Mercan
Yasser M
YM
El-Halafawy
D000233:Adenoidectomy; D017109:Akathisia, Drug-Induced / Q000209:etiology / Q000517:prevention & control*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000494:pharmacology; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D015742:Propofol / Q000008:administration & dosage* / Q000494:pharmacology; D011446:Prospective Studies; D000077149:Sevoflurane; D014068:Tonsillectomy
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D005283:Fentanyl; D015742:Propofol