Clinical Study On Adopting Sufentanil To Prevent Emergence Agitation In Children After Palate Repair Surgery Undergoing General Anesthesia

Objective:To observe the preventive efficiency of intravenous injection of sufentanil 15 minutes before completion of surgery on emergence agitation in children undergoing cleft palate repair.Methods:A prospective randomized clinical trial was conducted with 80 patients (aged 1-4 years, weight 9.5-17.5 kg, ASA classification I-II and Cleft palate classification Ⅱ-Ⅲ.) Undergoing cleft palate repair surgery they were randomly assigned to four groups based on the table of random number: sufentanil group (Group A, B and C) and fentanyl group (Group F),20 in each group. General anesthesia was induced and maintained using midazolam, remifentanil, propofol and vecuronium. About 15 minutes before completion of surgery, Group A, B and C were respectively administrated intravenously sufentanil at dose of 0.10μg/kg,0.15μg/kg and 0.20μg/kg; Group F was administrated intravenously fentanyl at dose of 1μg/kg. Time of operation, time of respiration recovery, time to tracheal extubation, time of recovery, time to staying in PAGU, Wound bleeding, airway obstruction, PONV on recovery period were recorded. Meanwhile, Paediatric Anesthesia Emergence Delirium (PAED) scale, MAP, HR and SpO2 were recorded at time points of tracheal extubation(T1),awakening(T2) and leaving PACU(T3), respectively.Reults:Gender, age, weight, time of operation, bleeding volume and the volume of fluid input were no statistically significant difference among the four groups(P>0.05). Compared with Group C, time to tracheal extubation was significantly reduced in the Group A, B and F (P<0.05); compared with Group C and F, the time of recovery and time to staying in PACU were significantly reduced in the Group A and B(P<0.05). In the haemodynamics, Between groups comparison:compared to Group A and F, the MAP and HR at T2 and T3 were significantly reduced in Group B and C (P<0.05). Intra-group comparison: In the Group A, B, C and F, HR at T2 was significantly increased compared with T1(P<0.05), HR at T3 was also significantly increased compared with T1 and T20P<0.05). In the Group A, MAP was no statistically significant difference among the three time points (P>0.05); in the Group B, MAP at T2 was significantly decreased compared with Ti(P<0.05), MAP at T3 was higher than at T2(P<0.05); in the Group C, MAP at T2 and T3 was significantly decreased compared with T1 (P<0.05), but MAP at T3 was higher than at T2(P<0.05); in the Group F, MAP at T3 was higher than at T2(P<0.05). The incidence of hyoxemia, wound bleeding, airway obstruction and PONV on recovery period were no statistically significant difference among the four groups(P>0.05). In the PAED scale, Between groups comparison:compared to Group A and F, the PAED scale at T2 and T3 were significantly reduced in Group B and C (P<0.05). Intra-group comparison:In the Group A, there was no statistically significant difference among the three time points(P>0.05); in the Group B and C, compared to T1, PAED scale at T2 and T3was significantly decreased(P<0.05), and PAED scale at T3 was lower than at T2 (P<0.05); in the Group F, PAED scale at T3 was higher than at T1 and T2.Conclusion:Administration of different concentrations of sufentanil and fentanyl about 15 minutes before completion of surgery in childern undergoing palate repair can reduced emergence agitation. Sufentanil 0.15 μg/kg and 0.20 μg/kg were better than sufentanil 0.10 μg/kg and fentanyl 1μg/kg.