Effects of Fentanyl and Dexmedetomidine Infusion on Tracheal Intubation and Emergence Agitation in Children Anesthetized with Sevoflurane
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- Category: Vol. 80, June 2012
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Effects of Fentanyl and Dexmedetomidine Infusion on Tracheal Intubation and Emergence Agitation in Children Anesthetized with Sevoflurane,SAMY A. AMR and MOHAMED A. OSMAN
Abstract
Background: Emergence agitation (EA) is a common side effect after anesthesia with sevoflurane as a sole agent in children. Fentanyl and dexmedetomidine, can be used to facilitate intubation and decrease emergence agitation. This study was designed to evaluate the efficacy of adding either fentanyl or dexmedetomidine on conditions at intubation and on emergence from sevoflurane anesthesia without confounding nitrous oxide or premedication.
Methods: This study was approved by Our Clinical Ethical Committee and written consents were obtained from parents prior entry into the study. This study included a total number of (150) patients, ASA physical status I, and their ages range between (2-8years). Patients were randomly allocated to receive either i.v. saline (control group), a bolus dose of fentanyl 2mg/kg followed by a continuous infusion of 1mg/kg/h (group F), or a bolus dose of dexmedetomidine 0.75mg/kg followed by a continuous infusion of 0.5mg/kg/h (group D). Anesthesia was induced with sevoflurane in oxygen and maintained using a predetermined concentration of sevoflurane. Sevoflurane minimum alveolar concentration for tracheal intubation (MACTI) was assessed. After extubation. Agitation parameters were measured using a five-point scale, agitated children were managed by giving intravenous increments of fentanyl 1mg/kg. Postoperative fentanyl consumption, incidence of postoperative nausea and vomiting and the time of hospital discharge allowance were recorded.
Results: MACTI value were (2.64%, 1.35% and 1.31%) in control group, group F and group D respectively (p<0.05) with no deference between group F and D. Incidence of postoperative agitation, amount of fentanyl consumption and nausea and vomiting were significantly higher in control group (p<0.001). No significant difference between the three groups in the time of hospital discharge allowance.
Conclusion: Adding either fentanyl infusion or dexme-detomidine infusion in a proper doses facilitate tracheal intubation and reduced sevoflurane-related emergence agitation with high safety profile.