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CLINICAL TRIAL article

Front. Pediatr.
Sec. Obstetric and Pediatric Pharmacology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1353027

Effects of Prophylactic Nalbuphine on Emergence Agitation and Postoperative Pain in Pediatric Patients Undergoing ENT Surgery with Sevoflurane Anesthesia

Provisionally accepted
Wendong Han Wendong Han 1Jingjie Cai Jingjie Cai 1Zhang Wangping Zhang Wangping 2*Rong Wei Rong Wei 1Yan Jiang Yan Jiang 1
  • 1 Shanghai Children's Hospital, Shanghai, Shanghai Municipality, China
  • 2 Jiaxing University, Jiaxing, China

The final, formatted version of the article will be published soon.

    Background: Emergence agitation (EA) is a common complication in the pediatric population. This study aimed to investigate the effect of the prophylactic nalbuphine on EA in pediatric patients receiving sevoflurane anesthesia. Methods: The children undergoing ear, nose, and throat (ENT) surgery were administered 0.2 mg/kg nalbuphine (the nalbuphine group) or the same volume of normal saline (the control group) 5 min before the end of the surgery. The extubating time, time to eye-opening and duration of the post-anesthesia care unit (PACU) were recorded. Heart rate and blood pressure were monitored before and 5 min after nalbuphine administration. Pain was assessed using Face Legs Activity Cry and Consolability (FLACC) scales, and the drug-related postoperative complications (e.g., EA, delayed awakening, nausea and vomiting, and respiratory depression) were recorded. Results: One-hundred and thirty pediatric patients were randomly divided into nalbuphine and control groups (n = 65). The nalbuphine group showed a significantly lower incidence of EA than the control group (20%vs 46.2%, P=0.002). No significant differences between the two groups were observed in heart rate and blood pressure 5 min after nalbuphine administration (P > 0.05). No significant differences were observed between the two groups regarding extubating time, time to eye-opening, and duration of PACU. The FLACC scales demonstrated lower values in the nalbuphine group than in the control group during the initial 4 hours after the surgery. However, the FLACC scales showed similar values between 5 and 12 hours after the surgery. Conclusions: In summary, the results of this study demonstrated that prophylactic nalbuphine could minimize the incidence of EA in pediatric patients receivfollowing ENT surgery without increasing the extubating time and PACU duration.

    Keywords: Nalbuphine, agitation, sevoflurane, general anesthesia, Children

    Received: 09 Dec 2023; Accepted: 02 Sep 2024.

    Copyright: © 2024 Han, Cai, Wangping, Wei and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhang Wangping, Jiaxing University, Jiaxing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.