Effect of dezocine on emergence agitation during recovery from sevoflurane-based anesthesia in children / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of dezocine on emergence agitation (EA) during recovery from sevoflurane-based anesthesia in children.Methods Ninety ASA Ⅰ or Ⅱ children,aged 3-6 yr,weighing 14-31 kg,were randomized into 3 groups (n =30 each)fentanyl group (group F),dezocine group (group D)and control group (group C).Anesthesia was induced with inhalation of 8 ％ sevoflurane and iv injection of atracurium 0.5 mg/kg and remifentanil 1 μg/kg and maintained with inhalation of 2％-3 ％ sevoflurane and infusion of remifentanil at 0.1-1.0 μg· kg-1 · min-1.In groups F,D and C,fentanyl 2 μg/kg,dezocine 0.05 mg/kg and the equal volume of normal saline were injected intravenously 10 min before the end of surgery,respectively,and inhalation of sevoflurane was stopped at the end of operation.The extubation time and length of stay in the postanesthesia care unit (PACU) were recorded.Agitation and the duration were recorded when the children were in PACU.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Pain was evaluated using the Children' s Hospital of Eastern Ontario Pain Scale (CHEOPS) and sedation was measured with Ramsay score.The complications such as respiratory depression,postoperative nausea and vomiting were recorded within 24 h after operation.Results Compared with group C,the incidence of EA and PAED scores were significantly decreased and the duration of EA was shortened in groups F and D,CHEOPS scores were decreased at each time point after operation and Ramsay scores were increased at T1 in group F,and CHEOPS scores were decreased and Ramsay scores were increased at each time point after operation in group D (P ＜ 0.05).Compared with group F,the incidence of EA and PAED scores were significantly decreased,CHEOPS scores were decreased at each time point after operation,and Ramsay scores were increased at T2 (P ＜ 0.05),and no significant change was found in the duration of EA in group D (P ＞ 0.05).There was no significant difference in the extubation time and length of stay in the PACU between the three groups (P ＞ 0.05).Conclusion Dezocine 0.05 mg/kg can safely and effectively prevent EA during recovery from sevoflurane-based anesthesia in children and produces better efficacy than fentanyl.