Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2024
The performance of a post-induction fentanyl-test in predicting postoperative respiratory adverse events in children after adenotonsillectomy.
Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04527393 (Effects of Individualized Opioid Analgesia Versus Conventional Opioid Analgesia After Adenotonsillectomy in Children), which is not on this map. Not yet cited in PubMed.
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Effects of Individualized Opioid Analgesia Versus Conventional Opioid Analgesia After Adenotonsillectomy in Children
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2 authors.
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Abstract
STUDY
objectivesPostoperative respiratory adverse events (PRAE) occurred more frequently in children having adenotonsillectomy than the general surgical population, and can require escalation of care. This study aims to assess the usefulness of postinduction fentanyl-test to predict PRAE in children with obstructive sleep apnea after adenotonsillectomy.
methodsTwo hundred and forty patients with obstructive sleep apnea undergoing adenotonsillectomy were included in this study. The oxygen saturation during sleep was monitored the night before adenotonsillectomy. Fentanyl-test was conducted under spontaneous breath after anesthesia induction with sevoflurane. Fentanyl-induced reduction in respiratory rate (FRR) was defined as the percentage of reduction in respiratory rate after 1 mcg/kg fentanyl administration. PRAE in the postanesthesia care unit included both respiratory complications and medical interventions. Receiver operating characteristic analysis was used to assess the usefulness of fentanyl-test in predicting PRAE.
resultsOf the 240 children undergoing elective adenotonsillectomy, 38 children (16%) experienced PRAE in postanesthesia care unit. The areas under receiver operating characteristic curve for FRR and nadir pulse oxygen saturation were 0.756 and 0.692, respectively. FRR greater than 53% best predicted PRAE in postanesthesia care unit, with a sensitivity of 68% and a specificity of 72%. Patients with FRR > 53% exhibited a significantly longer duration of desaturation requiring supplementary oxygen than those with FRR ≦ 53% (
conclusionsWe suggest that postinduction fentanyl-test is a feasible evaluation for children undergoing adenotonsillectomy to predict early PRAE, especially for those who have not undergone polysomnography. CLINICAL
trial registrationRegistry: ClinicalTrials.gov; Name: Effects of Individualized Opioid Analgesia Versus Conventional Opioid Analgesia After Adenotonsillectomy in Children; URL: https://clinicaltrials.gov/study/NCT04527393; Identifier: NCT04527393. CITATION: Liu H-E, He L. The performance of a post-induction fentanyl-test in predicting postoperative respiratory adverse events in children after adenotonsillectomy.
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