TY - JOUR
T1 - The effect of remifentanil or fentanyl on postoperative vomiting and pain in children undergoing strabismus surgery
AU - Eltzschig, Holger K.
AU - Schroeder, Torsten H.
AU - Eissler, B. Jürgen
AU - Felbinger, Thomas W.
AU - Vonthein, Reinhard
AU - Ehlers, Raila
AU - Guggenberger, Heinz
PY - 2002
Y1 - 2002
N2 - Postoperative vomiting (POV) after strabismus surgery in children results in discomfort and prolonged hospital stays. Opioids increase the incidence of POV. Remifentanil has a context-sensitive half-life of 3 to 4 min, and how this short half-life influences POV in those patients is unknown. We conducted a prospective, double-blinded study in 81 ASA status I or II children from 2 to 12 yr of age undergoing elective strabismus surgery under general anesthesia. Patients were randomized to receive either remifentanil (bolus 1 μg/kg; infusion 0.1-0.2 μg·kg-1·min-1) or fentanyl (2 μg/kg, and 1 μg/kg every 45 min). POV episodes were recorded for 25 h. Pain scores were obtained by using an objective pain scale for 60 min during recovery. The number of patients who experienced POV did not differ significantly between groups (49% vs 48%). However, in the Remifentanil group, POV episodes were significantly less frequent (0.95 vs 2.2 episodes). In contrast, fentanyl was associated with lower pain scores during the first 30 min of recovery. We conclude that children undergoing strabismus surgery under balanced anesthesia with remifentanil, compared with fentanyl, showed less frequent POV. However, early postoperative analgesia was better with fentanyl.
AB - Postoperative vomiting (POV) after strabismus surgery in children results in discomfort and prolonged hospital stays. Opioids increase the incidence of POV. Remifentanil has a context-sensitive half-life of 3 to 4 min, and how this short half-life influences POV in those patients is unknown. We conducted a prospective, double-blinded study in 81 ASA status I or II children from 2 to 12 yr of age undergoing elective strabismus surgery under general anesthesia. Patients were randomized to receive either remifentanil (bolus 1 μg/kg; infusion 0.1-0.2 μg·kg-1·min-1) or fentanyl (2 μg/kg, and 1 μg/kg every 45 min). POV episodes were recorded for 25 h. Pain scores were obtained by using an objective pain scale for 60 min during recovery. The number of patients who experienced POV did not differ significantly between groups (49% vs 48%). However, in the Remifentanil group, POV episodes were significantly less frequent (0.95 vs 2.2 episodes). In contrast, fentanyl was associated with lower pain scores during the first 30 min of recovery. We conclude that children undergoing strabismus surgery under balanced anesthesia with remifentanil, compared with fentanyl, showed less frequent POV. However, early postoperative analgesia was better with fentanyl.
UR - http://www.scopus.com/inward/record.url?scp=0036241720&partnerID=8YFLogxK
U2 - 10.1097/00000539-200205000-00022
DO - 10.1097/00000539-200205000-00022
M3 - Journal articles
C2 - 11973184
AN - SCOPUS:0036241720
SN - 0003-2999
VL - 94
SP - 1173
EP - 1177
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 5
ER -