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Purpose <p>This study was designed to assess the effects of sufentanil combined with remifentanil on hemodynamics during induction and postoperative recovery quality in preschool children undergoing tonsillectomy and adenoidectomy.</p> Methods <p>A total of 90 pediatric patients undergoing tonsillectomy and adenoidectomy under general anesthesia from October 2024 to March 2025 were included and randomly stratified to receive either Group R or Group S with equal probability. In Group R, anesthesia induction used sufentanil (0.2&#xa0;µg/kg) combined with remifentanil (2&#xa0;µg/kg), while only sufentanil (0.4&#xa0;µg/kg) was used for anesthesia induction in Group S. The rest of the induction drugs were the same in both groups. After drug administration, patient vital signs, such as heart rate (HR) and mean arterial pressure (MAP), were monitored and recorded before induction (T0), immediately before tracheal intubation (T1), 1&#xa0;min after tracheal intubation (T2), immediately after mouth gag placement (T3), immediately after extubation (T4), and 5&#xa0;min post-extubation (T5), respectively. Additional outcomes of interest included anesthesia recovery time, an intubation condition score (Copenhagen Consensus Scale), emergence agitation (Pediatric Anesthesia Emergence Delirium [PAED] score), a postoperative pain assessment score (Face, Legs, Activity, Cry, and Consolability [FLACC] score), and adverse events.</p> Results <p>The primary outcome is postoperative awakening time (the time from the end of surgery to tracheal tube removal), which was shorter in Group R than in Group S, but this difference was not statistically significant (<i>P</i> &gt; 0.05). The secondary outcomes include intraoperative hemodynamic parameters, intubation condition score (Copenhagen Consensus Scale), emergence agitation (Pediatric Anesthesia Emergence Delirium [PAED] score), a postoperative pain assessment score (Face, Legs, Activity, Cry, and Consolability [FLACC] score), and adverse events containing agitation during the awakening period, respiratory obstruction, nausea and vomiting, hypoxemia, and bradycardia. MAP was lower in Group R than in Group S at all time points, and was significantly lower at T3 (<i>P</i> &lt; 0.05). HR was lower in Group R than in Group S at most time points, including being significantly lower at T2 (<i>P</i> &lt; 0.05). No statistically significant differences were found between the two groups among the aforementioned secondary outcomes.</p> Conclusions <p>Among preschool children undergoing tonsillectomy and adenoidectomy, the combination of sufentanil and remifentanil in general anesthesia ensured stable hemodynamics during induction and surgery, reduced the total dose of opioid anesthetics, shortened recovery time without compromising quality, and led to no significant adverse reactions.</p> Trial registration <p>China Clinical Trial Center with registration number: ChiCTR2400090213,09/26/2024.</p>

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Effects of sufentanil combined with remifentanil on hemodynamics during induction and postoperative recovery quality in preschool children undergoing tonsillectomy and adenoidectomy

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  • 发表日期：

    2025年8月29日

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  • Xinlei Lu,
  • Siyue Li,
  • Ye Xuan,
  • Mengting Shen,
  • Weiping Lei,
  • Yaqin Huang,
  • Yibin Tao,
  • Yuan Cheng,
  • Jianliang Sun

摘要

Purpose

This study was designed to assess the effects of sufentanil combined with remifentanil on hemodynamics during induction and postoperative recovery quality in preschool children undergoing tonsillectomy and adenoidectomy.

Methods

A total of 90 pediatric patients undergoing tonsillectomy and adenoidectomy under general anesthesia from October 2024 to March 2025 were included and randomly stratified to receive either Group R or Group S with equal probability. In Group R, anesthesia induction used sufentanil (0.2 µg/kg) combined with remifentanil (2 µg/kg), while only sufentanil (0.4 µg/kg) was used for anesthesia induction in Group S. The rest of the induction drugs were the same in both groups. After drug administration, patient vital signs, such as heart rate (HR) and mean arterial pressure (MAP), were monitored and recorded before induction (T0), immediately before tracheal intubation (T1), 1 min after tracheal intubation (T2), immediately after mouth gag placement (T3), immediately after extubation (T4), and 5 min post-extubation (T5), respectively. Additional outcomes of interest included anesthesia recovery time, an intubation condition score (Copenhagen Consensus Scale), emergence agitation (Pediatric Anesthesia Emergence Delirium [PAED] score), a postoperative pain assessment score (Face, Legs, Activity, Cry, and Consolability [FLACC] score), and adverse events.

Results

The primary outcome is postoperative awakening time (the time from the end of surgery to tracheal tube removal), which was shorter in Group R than in Group S, but this difference was not statistically significant (P > 0.05). The secondary outcomes include intraoperative hemodynamic parameters, intubation condition score (Copenhagen Consensus Scale), emergence agitation (Pediatric Anesthesia Emergence Delirium [PAED] score), a postoperative pain assessment score (Face, Legs, Activity, Cry, and Consolability [FLACC] score), and adverse events containing agitation during the awakening period, respiratory obstruction, nausea and vomiting, hypoxemia, and bradycardia. MAP was lower in Group R than in Group S at all time points, and was significantly lower at T3 (P < 0.05). HR was lower in Group R than in Group S at most time points, including being significantly lower at T2 (P < 0.05). No statistically significant differences were found between the two groups among the aforementioned secondary outcomes.

Conclusions

Among preschool children undergoing tonsillectomy and adenoidectomy, the combination of sufentanil and remifentanil in general anesthesia ensured stable hemodynamics during induction and surgery, reduced the total dose of opioid anesthetics, shortened recovery time without compromising quality, and led to no significant adverse reactions.

Trial registration

China Clinical Trial Center with registration number: ChiCTR2400090213,09/26/2024.