The Effect of Remifentanil on Delirium after Sevoflurane Anesthesia in the Pediatric Patients

Abstract

BACKGROUND: Sevoflurane is commonly used anesthetics for pediatric surgical patients. Emergence delirium is more frequent when recovering from sevoflurane anesthesia than other anesthetics. In this study, we evaluated the effect of remifentanil to reduce emergence delirium after sevoflurane anesthesia in pediatric patients. METHODS: Children (3‐7 yrs) were randomly assigned to three groups: sevoflurane with normal saline in group N (0.06 ml/kg/ hr), sevoflurane with remifentanil (0.1microgram/kg/min) in group R, and sevoflurane with remifentanil (0.1microgram/kg/min) and remifentanil (0.05microgram/kg/min) till the recovery room in group RC. Time to extubation, Pediatric Anesthesia Emergence Delirium Scale (PAEDS), Objective Pain Scale (OPS), Modified Aldrete Score (MAS), and postoperative side effects in the recovery room were compared among three groups. RESULTS: Time to extubation (N; 9.3 +/‐ 3.5, R; 12.2 +/‐ 6.4, RC; 12.7 +/‐ 5.3 min) in R and RC group was prolonged compared with N group (P < 0.05). There were no differences among three groups in MAS. OPS has variable differences among the groups (P < 0.05). PAEDS was significantly reduced in RC group compare with R and N group (P < 0.05). CONCLUSIONS: Remifentanil did not reduce the incidence of emergence delirium after sevoflurane anesthesia in pediatric tonsillectomy. Emergence delirium after sevoflurane anesthesia was reduced by remifentanil infusion till the recovery room. [By kind permission, KoreaMed, Korean Association of Medical Journal Editors.]