소아 사시 환자에서 Desflurane 마취 시 Nalbuphine이 각성 흥분과 회복에 미치는 영향

Background: Emergence agitation frequently occurs after desflurane anesthesia in children. Nalbuphine, because of its sedative and analgesic properties, might be useful for the management of this side effect. We studied the effect of nalbuphine on recovery characteristics and emergence agitation after desflurane anesthesia in children for strabismus surgery. Methods: 41 patients (3-14 yr) scheduled for pediatric strabismus surgery were included. All children received ketamine 0.5 mg/kg intravenously before entering the operating room. After intravenous induction with thiopental and rocuronium to facilitate endotracheal intubation, patients were randomly assigned to receive saline, or nalbuphine 0.2 mg/kg respectively. Anesthesia was maintained with desflurane 4-6% with N2O：O2 = 2：1. At the end of anesthesia, time to cough, extubation, movement, eye opening and discharge were recorded. Emergence agitation was recorded by three point rating scale. Results: Agitation scores were significantly different between the two groups (P＜0.01). Time to extubation and movement were similar between two groups. Time to eye opening was significantly increased in nalbuphine group (P＜0.05). But, there was no difference in time to discharge from the recovery room to the ward between the two groups. Conclusions: In children undergoing strabismus surgery with desflurane anesthesia, nalbuphine 0.2 mg/kg administered immediately after induction reduced incidence of emergence agitation without delaying discharge from recovery room.