The Effects of Remifentanil and Remifentanil-Alfentanil Administration on Emergence Agitation After Brief Ophthalmic Surgery in Children
Overview
- Phase
- Not Applicable
- Intervention
- Sevoflurane
- Conditions
- Adverse Effect of Other General Anesthetics
- Sponsor
- Hallym University Medical Center
- Enrollment
- 102
- Primary Endpoint
- the incidence of emergence agitation
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Sevoflurane is widely and frequently used in pediatric anesthesia due to its non-irritating airway properties, rapid induction and emergence. However, it is associated with emergence agitation (EA) in children. EA may cause injury to the child or to the surgical site and is a cause of stress to both caregivers and families. Various pharmacologic agents have been suggested to reduce EA. But the effect of remifentanil on EA is still controversial. This study was designed to compare the effects of remifentanil and remifentanil combining alfentanil on EA in children undergoing ophthalmic surgery with sevoflurane anesthesia.
Detailed Description
One hundred and two children, aged 3-9 years, undergoing ophthalmic surgery were studied. General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane. At the time of separation from parents, separation score was recorded. When the children have a separation score of three or four point, they received half dose of thiopental before going to the operation room. They randomly assigned to group S (sevoflurane alone) or group R (sevoflurane with remifentanil infusion at the rate of 0.1 ㎍/kg/min) or group A (sevoflurane with remifentanil infusion and intravenous injection of alfentanil 5 ㎍/kg 10 min before the end of surgery). Mean arterial pressure (MAP), heart rate (HR) and sevoflurane concentration were checked every 15 minutes after induction of anesthesia. Time to extubation from discontinuation of sevoflurane inhalation was measured. Time to discharge from postanesthesia care unit (PACU) was assessed with postanesthetic Aldrete recovery score. Emergence agitation scoring system was used to evaluate the incidence and severity of EA.
Investigators
Eligibility Criteria
Inclusion Criteria
- •children who were scheduled to undergo ophthalmic surgery under general anesthesia
Exclusion Criteria
- •developmental delay, neurologic or psychologic disease,
- •history of sleep apnea,
- •or history of general anesthesia
Arms & Interventions
Sevoflurane
Anesthesia was maintained with sevoflurane,and the incidence and severity of emergence agitation was investigated.
Intervention: Sevoflurane
Sevoflurane
Anesthesia was maintained with sevoflurane,and the incidence and severity of emergence agitation was investigated.
Intervention: Thiopental
Sevoflurane
Anesthesia was maintained with sevoflurane,and the incidence and severity of emergence agitation was investigated.
Intervention: Rocuronium
Remifentanil
Anesthesia was maintained with sevoflurane and remifentanil. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Sevoflurane
Remifentanil
Anesthesia was maintained with sevoflurane and remifentanil. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Remifentanil
Remifentanil
Anesthesia was maintained with sevoflurane and remifentanil. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Thiopental
Remifentanil
Anesthesia was maintained with sevoflurane and remifentanil. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Rocuronium
Alfentanil
Anesthesia was maintained with sevoflurane and remifentanil, and alfentanil was administered 10 min before the end of surgery. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Sevoflurane
Alfentanil
Anesthesia was maintained with sevoflurane and remifentanil, and alfentanil was administered 10 min before the end of surgery. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Remifentanil
Alfentanil
Anesthesia was maintained with sevoflurane and remifentanil, and alfentanil was administered 10 min before the end of surgery. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Alfentanil
Alfentanil
Anesthesia was maintained with sevoflurane and remifentanil, and alfentanil was administered 10 min before the end of surgery. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Thiopental
Alfentanil
Anesthesia was maintained with sevoflurane and remifentanil, and alfentanil was administered 10 min before the end of surgery. The incidence and severity of emergence agitation was compared with sevoflurane group.
Intervention: Rocuronium
Thiopental
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Sevoflurane
Thiopental
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Remifentanil
Thiopental
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Alfentanil
Thiopental
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Thiopental
Thiopental
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Rocuronium
Rocuronium
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Sevoflurane
Rocuronium
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Remifentanil
Rocuronium
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Alfentanil
Rocuronium
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Thiopental
Rocuronium
General anesthesia was induced with thiopental 5 mg/kg, rocuronium 0.6 mg/kg and sevoflurane in all patients.
Intervention: Rocuronium
Outcomes
Primary Outcomes
the incidence of emergence agitation
Time Frame: during recovery time in PACU (within 1 hour)