Effects of fentanyl infusion on tracheal intubation and emergence agitation in preschool children anaesthetized with sevoflurane

Inomata, Shinichi; Maeda, Tatsuya; Shimizu, Takeru; Satsumae, Tsuyoshi; Tanaka, Makoto

doi:10.1093/bja/aeq168

Cited by 26 publications

(23 citation statements)

References 20 publications

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“…As a result of this, 45 articles published from 1999 to 2015 were complied with the selection criteria (Fig. 1)5678910111213141516171819202122232425262728293031323334353637383940414243444546474849. A total of 4,032 cases were included and the detailed baseline characteristics of the included studies were displayed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Wang

Huang

Gao

et al. 2016

Sci Rep

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Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay. Both traditional and network meta-analysis were carried in this study. A total of 45 articles were complied with the selection criteria and the corresponding articles were reviewed. Fentanyl demonstrated the highest cumulative ranking probability which was followed by those of ketamine and dexmedetomidine with respect to EA and PAED. When PONV and RA were concerned together, clonidine exhibited the highest cumulative ranking probability compared to other medications. Our study suggested that dexmedetomidine perhaps is the most appropriate prophylactic treatment which can be introduced into anesthesia for preventing emergence agitation.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Wang

Huang

Gao

et al. 2016

Sci Rep

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“…If airway obstruction does occur, inhalational anesthetic administration can be discontinued and the child can be woken up. A recent study reported that use of fentanyl allowed a dose-related smooth intubation and calm emergence in children anesthetized with sevoflurane [16]. In our case, to avoid tongue-fall into the retrolingual space, which can lead to severe airway obstruction, we chose anesthetic induction with 8% sevoflurane administered via a facemask and IV fentanyl, and intubation without a muscle relaxant.…”

Section: Discussionmentioning

confidence: 96%

Anesthetic Management of a Child with Simpson-Golabi-Behmel Syndrome—A Case Report

Morita¹,

Naito²,

Kimoto³

et al. 2015

OJAnes

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Simpson-Golabi-Behmel syndrome (SGBS) is an X-linked recessive condition associated with prenatal and postnatal overgrowth with visceral and skeletal anomalies. Abnormal airway anatomy may complicate the perioperative management of SGBS. However, there have been few reports regarding the anesthetic management of children with SGBS. We present the preoperative evaluation and intraoperative management of a 1.5-year-old child with SGBS undergoing plastic surgery for cleft palate. Sevoflurane-fentanyl anesthesia without a neuromuscular blocker was planned, due to the preoperative evaluation that airway management would be complicated by the macroglossia and short neck characteristic of SGBS. Fortunately, there was no difficulty in endotracheal intubation in the present patient due to careful planning of general anesthesia and meticulous airway management. Appropriate preoperative preparation for a difficult airway by the anesthesiologist can ameliorate the difficulties inherent to the anesthetic management of patients with SGBS.

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“…and propofol 1mg/kg at the end of sevoflurane anaesthesia effectively reduced the incidence of EA in children undergoing ambulatory inguinal hernia repair. In another investigation, Inomata et al 16 observed that a bolus of 2mcg/kg fentanyl followed by an infusion of 1mcg/kg/hr prevented emergence in children anaesthetized with sevoflurane. Though we have taken leads from earlier studies, our study differs in its design, patient population, and the dosage, route and timing of administration of study drugs and criteria used to assess EA.…”

Section: Similarly Kim Et Almentioning

confidence: 96%

Emergence agitation in children after sevoflurane anaesthesia: a comparative evaluation of ketamine and varying doses of fentanyl

Thomas¹,

Lagoo

Kilpadi³

2015

Sri Lankan J Anaesthesiol

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Introduction:Sevoflurane, inhalational anaesthetic of choice in children, is associated with high incidence of emergence agitation (EA). But that "one drug" which can significantly reduce or prevent EA still eludes us. Thus we aimed at studying the efficacy of intravenous ketamine and varying doses of intravenous fentanyl on postoperative emergence agitation in children receiving sevoflurane anaesthesia. Materials and methods:This prospective, double blind, randomized comparative study was conducted on 114 children, 2-10 years, with ASA physical status I-II. They were undergoing herniotomy under sevoflurane anaesthesia and were randomly divided into Group A receiving ketamine 0.5 mg/kg, Group B fentanyl 2mcg/kg and Group C fentanyl 3mcg/kg at the time of induction. Postoperatively emergence agitation was assessed every 5 min during first 60 min of PACU stay using Aono's four point scale. We also observed recovery characteristics including time to extubation, time to emergence, discharge from PACU and postoperative complications. Results: The incidence of EA was significantly low in Group A (31.6%) and Group C (28.9%) compared to group B (65.8%), with no significant difference between Group A and Group C. Incidence of EA was higher in preschool children. A prolonged PACU stay was observed in all children who developed EA, with lesser duration of PACU stay noted in fentanyl 3 mcg/kg group. Conclusion: Intravenous administration of either ketamine 0.5 mg/kg or fentanyl 3mcg/kg i.v. at the time of induction reduces the incidence of EA effectively when compared with fentanyl 2mcg/kg, without delaying recovery.

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Effects of fentanyl infusion on tracheal intubation and emergence agitation in preschool children anaesthetized with sevoflurane

Abstract: this study was started in 2000 and was finished in 2008. We had no registration number. IRB approval was obtained.

Cited by 26 publications

References 20 publications

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Anesthetic Management of a Child with Simpson-Golabi-Behmel Syndrome—A Case Report

Emergence agitation in children after sevoflurane anaesthesia: a comparative evaluation of ketamine and varying doses of fentanyl

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