Sufentanil Reduces Emergence Delirium in Children Undergoing Transthoracic Device Closure of VSD After Sevoflurane-Based Cardiac Anesthesia

Xu, Ning; Chen, Qiang; Huang, Shu-Ting; Kim, Sun; Cao, Hua

doi:10.21470/1678-9741-2019-0334

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…The incidence of PCA-related adverse events, especially PONV in sufentanil 5 μg/kg, were lower than that in the tramadol-containing regimen (ST group), which is in agreement with the study of Pang et al, 13 who found that PCA with additional tramadol provided effective analgesia following major orthopedic surgery, but there was a high incidence of nausea and vomiting. Our study is also consistent with Stassinos et al, 14 who confirmed frequent vomiting in tramadol-treated pediatric patients.…”

Section: Pca-related Adverse Eventssupporting

confidence: 90%

Effectiveness of Sufentanil‐Based Patient‐Controlled Analgesia Regimen in Children and Incidence of Adverse Events Following Major Congenital Structure Repairs

Xie

Liu

Zuo

2023

The Journal of Clinical Pharma

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The aim of this study was to evaluate postoperative analgesia effectiveness and patient‐controlled analgesia (PCA)‐related adverse events. The children who received sufentanil‐based PCA following major surgery to repair congenital hip dislocation and hypospadias were divided into 3 groups: sufentanil 4 µg/kg + tramadol 10 mg/kg (ST; n = 301), sufentanil 4 µg/kg (S4; n = 211), and sufentanil 5 µg/kg (S5; n = 451). Analgesics with granisetron 0.2 mg/kg were diluted in 0.9% saline to 100 mL and infused continuously at a basal infusion rate of 1 mL/h. A total of 963 children whose average age was 4 years were investigated. The incidence of moderate to severe postoperative pain during rest was significantly lower in the S5 group (0.2%) and ST group (0.3%) compared with the S4 group (3.3%) within 72 hours after surgery (P < .05), and the incidence of moderate to severe pain during activity within 72 hours was also significantly lower in the S5 group (3.5%) compared with the other 2 groups (ST, 21.9%; S4, 33.2%; P < .001). A significant difference was identified among the 3 groups in the total number of PCA administrations, but there was no statistical difference of total usage of opioids among the 3 groups. In terms of PCA‐related adverse events, the incidence of postoperative nausea and vomiting in the S5 group was lower compared with the ST group within 72 hours after surgery (P < .001), and there was no significant difference compared with the S4 group (P = .254). There was also no significant difference in the incidence of pruritus and dizziness among the 3 groups. Sufentanil‐based PCA can be effectively and safely used in children after major congenital structural malformation repair surgeries. The sufentanil 5 µg/kg dosage in the PCA regimen is superior to sufentanil 4 µg/kg alone or combined with tramadol in lowering moderate to severe pain.

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Section: Pca-related Adverse Eventssupporting

confidence: 90%

Effectiveness of Sufentanil‐Based Patient‐Controlled Analgesia Regimen in Children and Incidence of Adverse Events Following Major Congenital Structure Repairs

Xie

Liu

Zuo

2023

The Journal of Clinical Pharma

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“…Additionally, Sufentanil (26,716) has a higher therapeutic index than fentanyl (277) and morphine (71) according to preclinical studies, and it exhibits high bioavailability ( Helmers et al, 1989 ; Mather, 1995 ). Hence, sufentanil can exert greater analgesic effects over longer time compared with the same dose of fentanyl or morphine, and can lower the incidence of respiratory depression and adverse events ( Xu et al, 2020 ). Given the significant harm that opioid abuse poses to public health ( Volkow and McLellan, 2016 ), greater potency of sufentanil versus fentanyl and morphine may lead to accidental overdose of sufentanil ( Deeks, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of opioids for traumatic pain in the emergency department: a systematic review and Bayesian network meta-analysis

Fu¹,

Liu²,

Nie³

2023

Front. Pharmacol.

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Aim: To systematically assess and rank the efficacy of opioid medications for traumatic pain in the emergency department in terms of pain relief, adverse events and rescue analgesia.Methods: Four databases were systematically searched until 26 September 2022: PubMed, Embase, Cochrane Library, and Web of Science. Outcomes were pain relief, adverse events (dizziness, hypotension, pruritus, sedation), and rescue analgesia. For each outcome, network plots were drawn to exhibit direct and indirect comparisons, and rank probabilities were utilized to rank the efficacy of different opioids.Results: Twenty studies of 3,040 patients were eligible for this network meta-analysis. According to the rank probabilities, the top three analgesic medications for pain relief may be sufentanil (78.29% probability of ranking first), buprenorphine (48.54% probability of ranking second) and fentanyl (53.25% probability of ranking third); buprenorphine (31.20%), fentanyl (20.14%) and sufentanil (21.55%) were least likely to cause dizziness; the top three analgesic medications which were least likely to cause hypotension were buprenorphine (81.64%), morphine (45.02%) and sufentanil (17.27%); butorphanol (40.56%), morphine (41.11%) and fentanyl (14.63%) were least likely to cause pruritus; the top three medications which were least likely to cause sedation were hydrocodone + acetaminophen (97.92%), morphine (61.85%) and butorphanol (55.24%); patients who received oxycodone (83.64%), butorphanol (38.31%) and fentanyl (25.91%) were least likely to need rescue analgesia in sequence.Conclusion: Sufentanil, buprenorphine and fentanyl may be superior to other opioid medications in terms of pain relief and the incidence of dizziness, hypotension and pruritus, which might be selected as opioid analgesics for traumatic pain in the emergency setting.

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“…Through physical and mental nursing before and after the operation, the patients can have a deep understanding of the surgical process, the harm of emergence agitation, etc., so that the patients are in a relatively calm state for surgery. The observation and nursing of patients' status after general anesthesia, monitoring of patients' vital health status, timely feedback of patients' postoperative adverse reactions, and giving different degrees of psychological comfort to patients with emergence agitation can effectively reduce the threat to life and health [ 29 ]. To sum up, comfortable nursing could reduce the degree of pain of surgery, reduce the degree of agitation during postoperative recovery, and improve nursing satisfaction by adjusting the psychological state of patients during the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Functional Magnetic Resonance Imaging of Brain Function and Emergence Agitation of Patients with Dexmedetomidine-Assisted General Anesthesia under Comfortable Nursing Intervention

Gao

Zheng

Liu

et al. 2022

Computational Intelligence and Neuroscience

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In order to explore the effects of dexmedetomidine (DEX) on functional magnetic resonance imaging (fMRI) and emergence agitation of patients who underwent general anesthesia surgery with sevoflurane under comfortable nursing intervention, 66 patients who received upper abdominal surgery were selected as research objects. According to nursing and anesthesia methods, the patients were randomly divided into control group (routine nursing and anesthesia), group A (routine nursing and DEX-assisted anesthesia), and group B (comfortable nursing and DEX-assisted anesthesia). The differences in the brain fMRI characteristics, hemodynamic indexes, anesthesia recovery indexes, and nursing satisfaction in the perioperative period were evaluated. The results showed that the regional homogeneity values were different in different brain regions, but there was no difference in the Z value of functional connectivity P > 0.05 . Compared with the control group, heart rate, mean arterial pressure, awakening time, extubation time, the Riker sedation-agitation scale (SAS) score, and anesthetic dosage were signally decreased in group A and group B, while the Ramsay scores, the postanesthesia care unit (PACU) stay, and anesthesia maintenance time in the two groups was obviously increased P < 0.05 . Compared with group A, the extubation time, the SAS score, PACU stay, and hospital stay were all remarkably reduced in group B, while the nursing satisfaction score was greatly increased P < 0.05 . To sum up, DEX was helpful to safely and effectively reduce the occurrence of emergence agitation in patients under general anesthesia surgery with sevoflurane. Besides, comfortable nursing intervention could further reduce the incidence of emergence agitation in patients with general anesthesia, shorten the length of hospital stay, and improve nursing satisfaction.

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Sufentanil Reduces Emergence Delirium in Children Undergoing Transthoracic Device Closure of VSD After Sevoflurane-Based Cardiac Anesthesia

Cited by 5 publications

References 27 publications

Effectiveness of Sufentanil‐Based Patient‐Controlled Analgesia Regimen in Children and Incidence of Adverse Events Following Major Congenital Structure Repairs

Effectiveness of Sufentanil‐Based Patient‐Controlled Analgesia Regimen in Children and Incidence of Adverse Events Following Major Congenital Structure Repairs

Efficacy of opioids for traumatic pain in the emergency department: a systematic review and Bayesian network meta-analysis

Functional Magnetic Resonance Imaging of Brain Function and Emergence Agitation of Patients with Dexmedetomidine-Assisted General Anesthesia under Comfortable Nursing Intervention

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