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Anesthetic Pharmacology
Anesthesia and Pain Medicine 2007;2(2):61-66.
Published online April 30, 2007.
Effects of Supplemented Remifentanil/Meperidine to Sevoflurane Anesthesia on the Recovery in the Pediatrics Undergoing Tonsillectomy
Jeong Eun Mun, Hyun Joo Ahn, Jin Kyeong Kim, Jie Ae Kim
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Recovery from anesthesia, postoperative pain, nausea and vomiting are very important after pediatric tonsillectomy surgery. We compared the effects of supplemented opioids (remifentanil, meperidine) combined with sevoflurane on the recovery and side effects. METHODS: Patients were randomized to receive meperidine (group M, n = 41) or remifentanil (group R, n = 43). Group R received a bolus dose of normal saline, and group M 1 mg/kg of meperidine. A continuous infusion of normal saline was followed in the group M, and remifentanil 0.25micro/kg/min in the group R. In all patients, signs of inadequate anesthesia were treated with an increase of sevoflurane concentration. Intraoperative hemodynamics, recovery profiles, and side effects were assessed. RESULTS: Supplemented remifentanil resulted in significantly lower systolic blood pressure and heart rate during operation (P < 0.05). The emergence from anesthesia was not different between groups. Although the patients in the group R had early recovery characteristics at recovery room, time to discharge at recovery room was longer in the group R than in the group M (P < 0.05). The incidence of retching and vomiting was not different between groups. Supplemented meperidine resulted in less analgesic requirements than the other group (P < 0.05). CONCLUSIONS: Supplemented remifentanil was associated with hemodynamic stability, however it provided later discharge time at recovery room. Postoperative analgesic requirements were reduced by the supplemented meperidine without increasing postoperative nausea, vomiting.
Key Words: meperidine, remifentanil, tonsillectomy

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