Related Experiment Video

Updated: Jan 3, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

20.4K

The performance of a postinduction fentanyl test in identifying severe obstructive sleep apnea syndrome

Ru Wu1, Xuan Wang1, Peijun Zhuang1

  • 1Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China.

Paediatric Anaesthesia
|November 20, 2019
PubMed

Insights

A postinduction fentanyl test effectively identifies children with severe obstructive sleep apnea syndrome (OSAS), aiding in safer opioid use during surgery. This test helps predict respiratory risks in pediatric patients undergoing adenotonsillectomy.

Area of Science:

  • Anesthesiology and critical care medicine
  • Pediatric respiratory medicine
  • Sleep medicine

Background:

  • Children with severe obstructive sleep apnea syndrome (OSAS) exhibit heightened sensitivity to opioids.
  • Identifying these children is crucial for minimizing opioid-related risks, yet it remains a clinical challenge.
  • Previous research indicated that fentanyl sensitivity intraoperatively correlates with reduced postoperative opioid requirements.

Purpose of the Study:

  • To assess the efficacy of a postinduction fentanyl test in accurately identifying severe obstructive sleep apnea syndrome (OSAS) in pediatric patients.
  • To determine the sensitivity and specificity of this test compared to polysomnography.

Main Methods:

  • A prospective, observational, assessor-blinded study involved 104 children undergoing elective adenotonsillectomy.
  • A 1 µg/kg intravenous fentanyl dose was administered as a test before intubation in spontaneously breathing, sevoflurane-induced patients.
  • Respiratory rates were monitored pre- and post-fentanyl administration to evaluate the test's diagnostic performance.

Main Results:

  • The postinduction fentanyl test demonstrated a likelihood ratio of 7.2 and an AUC of 0.896 for identifying severe OSAS.
  • A >50% reduction in respiratory rate was established as the pragmatic cut-off, achieving 87% sensitivity and 88% specificity.
  • The test showed high predictive values: 85% positive and 89% negative, for detecting severe OSAS.

Conclusions:

  • The postinduction fentanyl test is a valuable tool with good predictive accuracy for identifying severe OSAS in children.
  • This test can help anticipate early postoperative adverse respiratory events.
  • Findings provide a basis for informed postoperative analgesia strategies in pediatric adenotonsillectomy patients.
Abstract

Keywords:
adenotonsillectomychildfentanylobstructiverespiratory ratesleep apnea

More Related Videos

Image Acquisition using Portable Sonography for Emergency Airway Management07:31

Image Acquisition using Portable Sonography for Emergency Airway Management

Published on: September 28, 2022

2.9K
Multi-Modal Home Sleep Monitoring in Older Adults07:40

Multi-Modal Home Sleep Monitoring in Older Adults

Published on: January 26, 2019

8.1K

Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
424
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.4K
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
529