Effect of intravenous fentanyl given prior to the end of surgery on emergence agitation in pediatric patients.

Author(s): Pattaravit N(1), Oofuwong M(2), Klaina S(2), Chuakham P(2).

Affiliation(s): Author information: (1)Department of Anesthesia, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. ngamjitp@yahoo.com (2)Department of Anesthesia, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Publication date & source: 2013, J Med Assoc Thai. , 96(12):1556-62

OBJECTIVE: Evaluate the effect of intravenous fentanyl on the incidence and severity of EA. MATERIAL AND METHOD: In the clinical trial, 144 patients aged between two and nine years, scheduled for elective surgery were enrolled and randomly assigned to receive either fentanyl 1 microg/kg or normal saline 1 ml/10 kg, 15 minutes before the end of surgery. Watcha's behavioral emergence delirium scale was used to assess EA. RESULTS: The incidence of EA was lower in the fentanyl group (11/72 vs. 23/72 person respectively, p = 0.03). However there was no statistically significant difference in the number of patients with severe EA (1/72 vs. 6/72 person respectively, p = 0.12). Fewer number of patients in the fentanyl group had moderate to severe pain when compared with the control group (16/72 vs. 30/72 person respectively, p = 0.02). The number of patient who required rescue analgesia was significantly lower in the fentanyl group (18/72 vs. 30/72 person respectively, p = 0.04). There were no statistically significant differences in terms of emergence time, postoperative adverse events, and length of stay in the post-anesthetic care unit between the two groups. CONCLUSION: Administration of intravenous fentanyl 1 microg/kg 15 minutes prior the end of surgery decreased the incidence of EA and reduced pain without delaying emergence and without any increase in postoperative complications.