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Nalbuphine as analgesic in preschool children undergoing ophthalmic surgery and the occurrence of emergence delirium
  1. Nicolas Leister1,
  2. Uwe Trieschmann1,
  3. Sirin Yücetepe1,
  4. Christoph Ulrichs1,
  5. Nikolas Muenke1,
  6. Stefanie Wendt2,
  7. Christoph Menzel1,
  8. Ludwig M Heindl3,4
  1. 1Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  2. 2Department of Cardiothoracic Surgery and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  3. 3Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  4. 4Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Dusseldorf, Cologne, Germany
  1. Correspondence to Dr Nicolas Leister, Department of Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Koln, Germany; nicolas.leister{at}uk-koeln.de

Abstract

Background/aims Perioperative pain in children is often inadequately treated, and emergence agitation is common. The purpose of this analysis was to determine whether nalbuphine is suitable for perioperative eye pain and to analyse if it influences the occurrence of emergence delirium/agitation (EDA) in children undergoing ophthalmic surgery in general anaesthesia.

Methods Retrospective cohort analysis of 50 children in preschool age undergoing general anaesthesia for ophthalmic surgery receiving nalbuphine as a postoperative analgesic in a German university hospital from June 2020 to February 2021.

Scores and values for pain and EDA were routinely recorded after awakening and during the stay in the recovery room. Data were evaluated retrospectively from the medical records.

Results A total of 50 children (17 girls and 33 boys) underwent general anaesthesia for ophthalmic surgery. The median age of the children included was 20.5 months (range, 1–68 months), the median body weight was 12.25 kg (range, 2.9–29 kg). All patients received ibuprofen (10 mg/kg1) during induction of anaesthesia and nalbuphine (0.1 mg/kg) at the end of surgery. All patients had an Paediatric-Anaesthesia-Emergence-Delirium-I-score (PAED-ED-I Score) of less than 6 and acceptable Face-Legs-Activity-Cry-Consolability-scores (FLACC less than 3) on waking and on leaving the recovery room.

Conclusion Nalbuphine shows a sufficient analgesic effect for pain therapy following ophthalmic surgery in preschool children. Nalbuphine seems to reduce the incidence of EDA in children undergoing ophthalmic surgery.

  • child health (paediatrics)
  • drugs
  • treatment medical

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Presented at Parts of the data were shown as an abstract presentation at the annual congress of the European Society of Anaesthesiology and Intensive Care (Euroanaesthesia, 17-19 December 2021).

  • Contributors NL: design of study, data collection, analysis of data, preparation of manuscript and review of manuscript, guarantor. LMH: design of study, data collection, analysis of data, preparation of manuscript and review of manuscript. UT, SY, CU and CM: data collection, analysis of data and review of manuscript. NM and SW: analysis of data and review of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.