Effects of remifentanil maintenance during recovery on emergence delirium in children with sevoflurane anesthesia.
Paediatr Anaesth
; 28(8): 739-744, 2018 08.
Article
en En
| MEDLINE
| ID: mdl-30004624
ABSTRACT
BACKGROUND:
Emergence delirium is a common complication of sevoflurane anesthesia in children.AIMS:
We examined the effects of maintaining remifentanil infusion during the recovery period on the incidence of emergence delirium in preschool-age children undergoing strabismus surgery under sevoflurane anesthesia.METHODS:
Eighty children (aged 3-7 years) were randomly assigned to either the control group (group C; intraoperative remifentanil infusion) or the intervention group (group R; intraoperative remifentanil infusion followed by remifentanil maintenance during the recovery phase). Intraoperative remifentanil infusion (0.2 µg/kg/min) was discontinued upon surgery completion in the group C, and was maintained until the discharge criteria were met at a dose of 0.05 µg/kg/min in the group R. The incidence of emergence delirium was assessed using a five-point agitation scale and the Pediatric Anesthesia Emergence Delirium scale after arrival in the postanesthesia care unit. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale.RESULTS:
The incidence of emergence delirium according to the five-point agitation scale (scores ≥ 4) was lower in the group R (33.3%) compared to the group C (68.3%) (odds ratio 0.206; 95% CI 0.080 to 0.531; P = 0.002). Similar results were obtained using the Pediatric Anesthesia Emergence Delirium scale (scores > 12), with an incidence of 5.1% in the group R and 34.0% in the control group (odds ratio 0.104; 95% CI 0.022 to 0.497; P = 0.001). The Children's Hospital of Eastern Ontario Pain Scale scores and occurrence of postoperative adverse events including laryngospasm, desaturation, nausea, and vomiting were similar between the two groups.CONCLUSION:
Maintaining a low dose of remifentanil (0.05 µg/kg/min) throughout the recovery phase attenuated the incidence of emergence delirium in children undergoing strabismus surgery under sevoflurane anesthesia.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Delirio del Despertar
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Sevoflurano
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Remifentanilo
Tipo de estudio:
Clinical_trials
Límite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Año:
2018
Tipo del documento:
Article