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芬太尼与舒芬太尼用于小儿腹股沟疝修补术后恢复时间的比较:一项随机临床试验。

Comparisons of fentanyl and sufentanil on recovery time after inguinal hernia repair in children: a randomized clinical trial.

机构信息

Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Hongshan District, Wuhan, 430070, China.

出版信息

BMC Surg. 2024 Feb 14;24(1):55. doi: 10.1186/s12893-024-02346-x.

Abstract

BACKGROUND

Inguinal hernia repair is a common pediatric procedure. We studied postoperative recovery times in children undergoing laparoscopic inguinal hernia repair with anesthesia induced by fentanyl versus sufentanil.

METHODS

We performed a pilot randomized clinical trial between February and December 2022. Eligible children were assigned into two age groups, 2-6 and 6-12 years old groups. Then, children in each age group were randomly assigned into either the fentanyl (2 µg/kg) or sufentanil (0.2 µg/kg) group for anesthesia induction. Baseline characteristics were collected. The primary outcome was the postoperative recovery time, which was recorded as the time period from extubation to a Steward recovery score reaching 6. Secondary outcomes included surgical duration, anesthetic duration, intubation duration, and intraoperative hemorrhage.

RESULTS

There were 300 children, with 75 children in each group. In the 2-6 years old group, children who received fentanyl had statistically significantly shorter postoperative recovery times than children who received sufentanil (0.9 ± 0.4 versus 1.5 ± 0.3 h, P < 0.001). However, in the 6-12 years old group, children who received fentanyl had statistically significantly longer postoperative recovery times than children who received sufentanil (1.2 ± 0.4 versus 0.8 ± 0.4 h, P < 0.001). Baseline characteristics and secondary outcomes were comparable between two groups.

CONCLUSIONS

Anesthesia induction with fentanyl or sufentanil resulted in different postoperative recovery times after laparoscopic inguinal hernia repair in children in different age groups. More studies are required to determine the appropriate induction anesthetic in children of different ages.

TRIAL REGISTRATION

The study protocol was retrospectively registered online at the Chinese Clinical Trial Registry (registration number ChiCTR2300072177, retrospectively registered on 06/06/2023).

摘要

背景

腹股沟疝修补术是一种常见的小儿手术。我们研究了芬太尼和舒芬太尼诱导麻醉下腹腔镜腹股沟疝修补术患儿的术后恢复时间。

方法

我们在 2022 年 2 月至 12 月期间进行了一项前瞻性随机临床试验。符合条件的患儿被分为 2-6 岁和 6-12 岁两个年龄组。然后,每个年龄组的患儿被随机分为芬太尼(2µg/kg)或舒芬太尼(0.2µg/kg)组进行麻醉诱导。收集基线特征。主要结局是术后恢复时间,定义为从拔管到 Steward 恢复评分达到 6 的时间。次要结局包括手术时间、麻醉时间、插管时间和术中出血。

结果

共有 300 名患儿,每组 75 名。在 2-6 岁年龄组中,接受芬太尼的患儿术后恢复时间明显短于接受舒芬太尼的患儿(0.9±0.4 与 1.5±0.3 h,P<0.001)。然而,在 6-12 岁年龄组中,接受芬太尼的患儿术后恢复时间明显长于接受舒芬太尼的患儿(1.2±0.4 与 0.8±0.4 h,P<0.001)。两组患儿的基线特征和次要结局相似。

结论

不同年龄组患儿腹腔镜腹股沟疝修补术后接受芬太尼或舒芬太尼诱导麻醉,术后恢复时间不同。需要进一步研究确定不同年龄患儿的合适诱导麻醉药物。

试验注册

研究方案于 2023 年 6 月 6 日在中国临床试验注册中心(注册号 ChiCTR2300072177)在线回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8519/10865580/8da8741df166/12893_2024_2346_Fig1_HTML.jpg

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