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Post-induction alfentanil reduces sevoflurane-associated emergence agitation in children undergoing an

J Y Kim1, Y J Chang, J Y Lee

  • 1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Acta Anaesthesiologica Scandinavica
|May 8, 2009
PubMed

Insights

Alfentanil effectively prevents emergence agitation in children after sevoflurane anesthesia for adenotonsillectomy. This opioid reduces agitation without prolonging recovery time, offering a safe option for pediatric patients.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Surgical Recovery

Background:

  • Emergence agitation is a frequent complication in pediatric anesthesia, particularly following sevoflurane-based volatile induction and maintenance anesthesia (VIMA).
  • This phenomenon can complicate postoperative care and patient experience.

Purpose of the Study:

  • To evaluate the efficacy of alfentanil in preventing emergence agitation.
  • To assess if alfentanil delays recovery after VIMA with sevoflurane in pediatric adenotonsillectomy patients.

Main Methods:

  • A randomized controlled trial involving 105 children (3-10 years) undergoing adenotonsillectomy.
  • Participants received either normal saline, alfentanil 10 mcg/kg, or alfentanil 20 mcg/kg post-induction.
  • Outcomes measured included tracheal extubation time, recovery time, and the Pediatric Anesthesia Emergence Delirium (PAED) scale.

Main Results:

  • Both alfentanil groups (10 and 20 mcg/kg) showed significantly lower incidence of severe agitation compared to the control group.
  • The PAED scale scores were significantly lower in the alfentanil groups versus the control.
  • No significant differences in agitation or PAED scores were observed between the two alfentanil dosage groups.
  • Tracheal extubation and recovery times remained similar across all groups.

Conclusions:

  • Alfentanil at 10 mcg/kg is effective in reducing emergence agitation in children undergoing adenotonsillectomy with VIMA.
  • This intervention does not appear to delay recovery or cause significant hypotension.
  • Alfentanil represents a viable option for managing emergence agitation in this pediatric surgical population.
Abstract

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