title: The effect of remifentanil on the incidence of agitation on emergence from sevoflurane anaesthesia in children undergoing adenotonsillectomy.
abstract: The aim of the present study was to assess the effect of remifentanil on the incidence of emergence agitation in preschool-aged children undergoing adenotonsillectomy with sevoflurane anaesthesia. Sixty children, aged three to seven years, American Society of Anesthesiologists physical status I or II, were randomised into either group S (sevoflurane alone, n=30) or group R (sevoflurane plus remifentanil, n=30). Anaesthesia was induced with an intravenous bolus injection of fentanyl 3 microg/kg and propofol 2.5 mg/kg. Endotracheal intubation was facilitated by vecuronium 0.1 mg/kg. All patients were ventilated with 50% nitrous oxide and 1.5 to 2.5% sevoflurane in oxygen. End-tidal CO2 was maintained at 35 +/- 4 mmHg. Group S received no other medication while group R received remifentanil 1 microg/kg/minute intraoperatively. Mean blood pressure, heart rate, pulse oximetry, eye-opening time and extubation time were recorded in the operating room. In recovery, emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium scale with a score > or =10 taken as indicating agitation. Emergence agitation occurred in 20 of the 30 patients in group S and seven of the 30 patients in group R (P < 0.01). In preschool-aged children undergoing adenotonsillectomy with sevoflurane general anaesthesia, after propofol and fentanyl induction, intraoperative remifentanil decreased the incidence of emergence agitation.
authors: Department of Anaesthesia, Shengjing Hospital, China Medical University Shenyang, Liaoning Province, China.
authors: Y X
authors: YX
authors: Dong
authors: L X
authors: LX
authors: Meng
authors: Y
authors: Y
authors: Wang
authors: J J
authors: JJ
authors: Zhang
authors: G Y
authors: GY
authors: Zhao
authors: C H
authors: CH
authors: Ma
mesh_terms: D000234:Adenoids / Q000601:surgery; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000627:therapeutic use; D011595:Psychomotor Agitation / Q000209:etiology / Q000517:prevention & control*; D000077208:Remifentanil; D000077149:Sevoflurane; D014068:Tonsillectomy / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol