Fentanyl reduces desflurane-induced airway irritability following thiopental administration in children

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Lee, J.; Oh, Y.; Kim, C.; Kim, S.; Park, H.; Kim, H.
Issue Date
Acta Anaesthesiol Scand. 2006 Oct;50(9):1161-4.
Analgesics, Opioid/adverse effects/*therapeutic useAnesthesia, General/*adverse effectsAnesthetics, Inhalation/*adverse effectsApnea/chemically induced/drug therapyBlood Pressure/physiologyChildChild, PreschoolCough/chemically induced/drug therapyDouble-Blind MethodElectrocardiographyFemaleFentanyl/adverse effects/*therapeutic useHeart Rate/physiologyHumansHypnotics and Sedatives/*adverse effectsInjections, Intravenous*IrritantsIsoflurane/adverse effects/*analogs & derivativesMaleMucus/secretionThiopental/*adverse effects
BACKGROUND: Airway irritation is a major drawback of desflurane anesthesia. This study was designed to evaluate the effect of intravenous fentanyl given before thiopental induction on airway irritation caused by a stepwise increase in desflurane in children. METHODS: Eighty children (2-8 years) were enrolled in a randomized, double-blind study. Forty received saline and 40 received 2 microg/kg of fentanyl intravenously; this was followed by thiopental sodium 5 mg/kg in both groups. Patients were assistant-ventilated with desflurane 1%, which was then increased by 1% every six breaths up to 10%. During this period, cough, secretion, excitation and apnea were graded and the desflurane concentration at which airway irritation symptoms first occurred was recorded. The results were analyzed using Pearson's chi-squared test. RESULTS: The incidence of typical airway irritation events was lower with fentanyl than with saline (cough, 2.5% vs. 42.5%; secretion, 27.5% vs. 82.5%; excitation, 10% vs. 82.5%; apnea, 20% vs. 65%; P < 0.05). The mean expired desflurane concentration at which the first airway irritation symptom occurred was greater with fentanyl than with saline (7.3% vs. 5.5%, P < 0.05). CONCLUSIONS: Intravenous fentanyl in children reduces airway complications caused by desflurane.
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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