Li Xiuze, Zhang Yonghong, Zhou Meijun, Xia Qing, Li Wei, Lu Qing
Department of Anesthesiology, Mianyang Central Hospital, 12 Changjia Lane, Mianyang, Sichuan, China.
Saudi Med J. 2013 Jan;34(1):40-5.
To conduct a comparative study of sufentanil and fentanyl on emergence agitation in pediatric patients.
We conducted a prospective, randomized, and double-blind study in 80 preschool children admitted at the Pediatric Surgery, Mianyang Central Hospital, Sichuan, China between March 2011 and April 2012. They underwent sevoflurane anesthesia for elective repair of unilateral inguinal hernia. Children received a single intravenous dose of sufentanil 0.15 ug/kg or fentanyl 1.5 ug/kg just before skin incision. The emergence agitation scale and the frequency of severe emergence agitation were measured. Patients who required additional fentanyl during surgery and postoperative rescue fentanyl were recorded. Recovery time and the incidence of adverse effects were assessed.
The mean emergence agitation scores were significantly lower in the sufentanil group compared with the fentanyl group (9.1+/-3.5 versus 12+/-3.8; 95% confidence interval [1.27+/-0.53]; p=0.001). The frequency of severe emergence agitation was 27.5% in the sufentanil group and 50% in the fentanyl group (p=0.039). Significantly fewer children in the sufentanil group received additional fentanyl during surgery compared to the fentanyl group (5% versus 20%; p=0.043) and significantly fewer children in the sufentanil group received one dose of postoperative rescue fentanyl compared to the fentanyl group (17.5% versus 42.5%; p=0.015). The incidence of vomiting was significantly higher in the fentanyl group than in the sufentanil group (p=0.023).
In preschool children undergoing repair of unilateral inguinal hernia with sevoflurane anesthesia, compared with a single dose of 1.5 ug/kg fentanyl, 0.15 ug/kg sufentanil before skin incision can significantly decrease the incidence of emergence agitation without delaying the recovery time.
对舒芬太尼和芬太尼用于小儿患者术后躁动进行对比研究。
2011年3月至2012年4月，在四川省绵阳市中心医院小儿外科，对80例择期行单侧腹股沟疝修补术的学龄前儿童进行前瞻性、随机、双盲研究。患儿接受七氟醚麻醉，在切皮前单次静脉注射舒芬太尼0.15μg/kg或芬太尼1.5μg/kg。记录术后躁动评分、严重躁动发生率、术中追加芬太尼及术后补救用芬太尼的情况、苏醒时间及不良反应发生率。
舒芬太尼组术后躁动评分显著低于芬太尼组（9.1±3.5比12±3.8；95%可信区间[1.27±0.53]；p = 0.001）。舒芬太尼组严重躁动发生率为27.5%，芬太尼组为50%（p = 0.039）。舒芬太尼组术中追加芬太尼的患儿明显少于芬太尼组（5%比20%；p = 0.043），术后补救用一剂芬太尼的患儿也明显少于芬太尼组（17.5%比42.5%；p = 0.015）。芬太尼组呕吐发生率显著高于舒芬太尼组（p = 0.023）。
在学龄前儿童七氟醚麻醉下行单侧腹股沟疝修补术时，切皮前单次静脉注射0.15μg/kg舒芬太尼较1.5μg/kg芬太尼能显著降低术后躁动发生率，且不延长苏醒时间。
