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Effect of Intravenous Fentanyl Given Prior to the End of Surgery on Emergence Agitation in Pediatric Patients

Ngamjit Pattaravit MD*, Maliwan Oofuwong MD*, Sangduen Klaina BSc*, Panyawee Chuakham BSc*

Affiliation : * Department of Anesthesia, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand


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 μg/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 μg/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.

Keywords : Emergence agitation, Pediatric, Fentanyl


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