Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study

Purpose: Emergence agitation (EA) after (adeno) tonsillectomy (AT) surgery impairs recovery in children. Adequate analgesia plays a crucial role in reducing EA incidence. This study investigated whether hydromorphone infusion (30 μg/kg) during anesthesia induction could reduce EA following AT surgery for obstructive sleep apnea in children. Patients and methods: A total of 186 ASA I–III children aged 3–7 years undergoing AT surgery were enrolled in a blinded randomized trial comparing hydromorphone (30 μg/kg) to fentanyl (4 μg/kg). The primary outcome was EA incidence within 30 min post-extubation. Secondary outcomes included pediatric anesthesia emergence delirium (PAED), face, legs, activity, crying, consolability (FLACC), Ramsay sedation scores, extubation time, rescue analgesia incidence, and adverse events. Results: The incidence of EA was significantly lower in the hydromorphone group [48.4% (45/93) vs 64.5% (60/93); absolute difference: 16.1%; 95% CI: 18.9–29.5%; P = 0.027]. Hydromorphone improved PAED, FLACC, and Ramsay scores and reduced moderate-to-severe pain and rescue analgesia. No postoperative complications occurred in either group. Conclusion: Hydromorphone at 30 μg/kg effectively reduces the incidence of EA within 30 min post-extubation in children after AT surgery compared to fentanyl. It shows superior analgesia and has a low incidence of adverse effects.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study ; volume:20 ; number:1 ; year:2025 ; extent:10 ; Open medicine ; 20, Heft 1 (2025) (gesamt 10)

Contributors, Places and Time

• Creator: Huang, Qiyuan ; Chen, Yang ; Sun, Xiaohui ; Su, Yongwei ; Zhou, Ruihao ; Chen, Guo ; Zhu, Tao

Further information

• DOI: 10.1515/med-2024-1129
• URN: urn:nbn:de:101:1-2502080605153.285839392646
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:21 AM CEST