title: Sufentanil reduces emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl.
abstract: BACKGROUND
  Emergence agitation is a common problem in pediatric anesthesia, especially after sevoflurane induction and maintenance anesthesia. The purpose of this study was to investigate the effect of sufentanil to reduce emergence agitation after sevoflurane anesthesia in children undergoing adenotonsillectomy compared with fentanyl.
  
  
  METHODS
  One hundred and five children, aged 3 - 11 years, were randomly allocated to receive normal saline (control group), sufentanil 0.2 µg/kg (S2) or fentanyl 2 µg/kg (F2) 1 minute after loss of the eyelash reflex. Anesthesia was induced and maintained with sevoflurane. Time to tracheal extubation, recovery time, Paediatric Anesthesia Emergence Delirium (PAED) scale, and emergence behavior were assessed.
  
  
  RESULTS
  The incidence of severe agitation was significantly lower in S2 and F2 groups vs. the control group, 4/32 and 15/34 vs. 24/34 respectively, (P = 0.002, 0.009, respectively). PAED scales were significantly different among three groups (P = 0.007), and lower in the S2 and F2 groups than in the control group (P = 0.007 and P = 0.025, respectively). And the incidence of severe agitation and the PAED scale score was significantly different between the S2 and F2 groups (P = 0.007, P = 0.019, respectively). Time to tracheal extubation and recovery time were similar in all three groups.
  
  
  CONCLUSIONS
  Administration of sufentanil at 0.2 µg/kg after induction of anesthesia reduced emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl. This was without delaying the recovery time or causing significant hypotension.
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical College, Wenzhou, Zhejiang 325027, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Zhi-Lian
authors.initials: ZL
authors.lastname: Huang
authors.forename: Xu-Tong
authors.initials: XT
authors.lastname: Zhang
authors.forename: Ke
authors.initials: K
authors.lastname: Luo
authors.forename: Zhan-Qin
authors.initials: ZQ
authors.lastname: Zhang
authors.forename: Yi
authors.initials: Y
authors.lastname: Mao
authors.forename: Xiao-Biao
authors.initials: XB
authors.lastname: Zhuang
authors.forename: Qing-Quan
authors.initials: QQ
authors.lastname: Lian
authors.forename: Hong
authors.initials: H
authors.lastname: Cao
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000758:Anesthesia / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000209:etiology*; D000077149:Sevoflurane; D017409:Sufentanil / Q000627:therapeutic use*
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D017409:Sufentanil; D005283:Fentanyl