J 2017

Reduction of paediatric emergence agitation after adenotonsillectomy with nalbuphine

VAVŘINA, Martin, Jiří ŽUREK, Michal FEDORA, Petr DOMINIK, Marie FORBELSKÁ et. al.

Basic information

Original name

Reduction of paediatric emergence agitation after adenotonsillectomy with nalbuphine

Authors

VAVŘINA, Martin (203 Czech Republic, guarantor, belonging to the institution), Jiří ŽUREK (203 Czech Republic, belonging to the institution), Michal FEDORA (203 Czech Republic, belonging to the institution), Petr DOMINIK (203 Czech Republic, belonging to the institution), Marie FORBELSKÁ (203 Czech Republic, belonging to the institution) and Julie BIENERTOVÁ VAŠKŮ (203 Czech Republic, belonging to the institution)

Edition

Current Pediatric Research, Aligarh, Scientific Publishers of India, 2017, 0971-9032

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30209 Paediatrics

Country of publisher

India

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

RIV identification code

RIV/00216224:14110/17:00098198

Organization unit

Faculty of Medicine

Keywords in English

Anaesthesia; Opioid analgesics; Volatile anaesthetics; Sevoflurane; Child; Emergence delirium

Tags

Tags

International impact, Reviewed
Změněno: 22/3/2018 15:43, Soňa Böhmová

Abstract

V originále

Abstract Background and aim: The aim of this prospective, observational study was to evaluate the potential benefit of nalbuphine in paediatric adenotonsillectomy in comparison to alfentanil in the terms of the emergence delirium and other procedural adverse events. Methods: Monitored adverse events were tachycardia, dyspnoea, hypotension, hypertension and emergence agitation according to the adapted Watcha scale. All eligible patients were given oral premedication and general anaesthesia was induced using inhalational or intravenous route. Patients were given nalbuphine (0.1-0.2 mg.kg-1) or alfentanil (10-15 ug.kg-1) and had all requested data recorded in the study form (age, study group, metamizole usage, body weight, total dose of nalbuphine or alfentanil, ASA, studied parameters). Results: Total of 122 patients were enrolled for this study, 8 patients were excluded because of incomplete study form. This resulted in study population of 114 patients. All patients were ASA I–II. No differences in age or body weight were observed. Emergence agitation was significantly (p=0.024) more frequent in the Alfentanil group (39.66%) than in Nalbuphine group (19.64%). Tachycardia was significantly more frequent in younger patients. Dyspnoea was significantly dose-dependent and more frequent in lower dosages (p=0.045). Hypertension was more frequent in patients with higher grade of agitation, but statistically significant only in the Alfentanil group (p=0.044). Conclusion: Nalbuphine in the setting of paediatric adenotonsillectomy makes a good alternative to short acting opioid and postoperative analgesia using NSAID or other nonopioid analgesics. Our results show that nalbuphine provides less emergence agitation and therefore provides a patient better early postoperative outcome.