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CompletedNCT03343002Updated Aug 8, 2019

Effect of Intravenous Fentanyl on the Occurrence of Postoperative Nausea and Vomiting According to Time of Administration Around the End of Tonsillectomy With or Without Adenoidectomy

An interventional study of fentanyl at 10-15 min before end of surgery and fentanyl at end of surgery in Follicular Tonsillitis (Chronic), sponsored by Yonsei University. Completed at 1 site in Korea, Republic of. Open to participants aged 3 Years to 7 Years. Per ClinicalTrials.gov, last updated 2019-08-08.

Sponsored by Yonsei University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
3 Years to 7 Years
Sex
All
01

Study summary

Fentanyl is a commonly used drug for the prevention of emergence agitation and reduction in postoperative pain in children receiving tonsillectomy. However, fentanyl can cause postoperative nausea and vomiting (PONV), which is a main target side effect that medical staff strives to prevent. However, recent meta-analysis showed that the incidence of PONV may be different depending on the time of administration of fentanyl. However, the research design of patients enrolled in each study, such as the age, the name of the operation, and the method of anesthesia, is not identical. The aim of this study was to evaluate the efficacy and safety of fentanyl in patients undergoing tonsillectomy with a prospective randomized controlled trial. Secondary outcomes include incidence and severity of emergence agitation and anesthesia recovery time, postanesthesia care unit (PACU) time, side effects.

02

Conditions studied

  • Follicular Tonsillitis (Chronic)
03

Who can participate

Ages eligible
3 Years to 7 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Pediatric patients aged 3 to 7 years with ASA 1-II scheduled for tonsillectomy (or adenoidal tonsillectomy)

Exclusion criteria

Exclusion Criteria:

    1. History of developmental disorder, cognitive impairment, cerebral palsy
    1. History of seizures(not simple febrile convulsions)
    1. Upper respiratory infections
    1. Structural airway disease predicting difficult airway
    1. History of an adverse reaction, including allergic reactions to fentanyl
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
140 participants (actual)

Study arms

  • Experimental
    fentanyl at 10-15 min before end of surgery

    Drug: fentanyl at 10-15 min before end of surgery

  • Active comparator
    fentanyl at end of surgery

    Drug: fentanyl at end of surgery

Interventions

  • Drugfentanyl at 10-15 min before end of surgery

    Label 2 syringe is filled with 1mcg/kg of fentanyl, label 1 syringe is filled with same amount of saline solution. If the surgeon notifies the anesthesiologist 10-15 minutes before the end of the operation, the syringe drug labeled 1 will be administered intravenously(that is, normal saline ). At the end of the surgery, the syringe drug labeled 2 is administered intravenously((that is, 1mcg/kg of fentanyl)

  • Drugfentanyl at end of surgery

    Label 2 syringe is filled with 1mcg/kg of fentanyl, label 1 syringe is filled with same amount of saline solution. If the surgeon notifies the anesthesiologist 10-15 minutes before the end of the operation, the syringe drug labeled 1 will be administered intravenously(that is, normal saline ). At the end of the surgery, the syringe drug labeled 2 is administered intravenously((that is, 1mcg/kg of fentanyl)

05

What researchers measure

Primary outcomes

  1. Incidence of postoperative nausea and vomiting

    Occurrence of nausea and vomiting- Described as yes/no (Observation of medical personnel or Subjective symptoms of the patient by the definition below) Nausea: "feeling of the urge to vomit" vomiting: "retching and any expulsion of liquid gastric contents"

    Time frame: In 10-minute increments from immediately(less than 3 min) after entering PACU to departure

Secondary outcomes

  1. PAED scale score: *Pediatric Anesthesia Emergence Delirium scale: range 0-20 points. If the score is more than 12, it is considered to be EA occurrence.

    \*Pediatric Anesthesia Emergence Delirium scale: range 0-20 points. If the score is more than 12, it is considered to be EA occurrence.

    Time frame: In 10-minute increments from immediately(less than 3 min) after entering PACU to departure

  2. five-step EA scale: *five-step Emergence Agitation scale: range 1-5 score. If the score is 4 or more, it is regarded as EA occurrence.

    \*five-step Emergence Agitation scale: range 1-5 score. If the score is 4 or more, it is regarded as EA occurrence.

    Time frame: In 10-minute increments from immediately(less than 3 min) after entering PACU to departure

  3. FLACC score FLACC score (Face, Legs, Activity, Cry, Consolability scale): range 0-10. If the score is 4 or more, Pain control is considered necessary.

    Time frame: In 10-minute increments from immediately after entering PACU to departure

  4. anesthesia recovery time

    \<1\> time until regular respiration is possible after end of surgery , \<2\>time to extubate after end of surgery, and \<3\>eye opening time in response to initial verbal command after end of surgery

    Time frame: up to 1 day after end of surgery

  5. Occurrence of side effect

    airway obstruction, laryngospasm, desaturation, drowsiness, pruritus, hypotension, bradycardia

    Time frame: In 10-minute increments from immediately(less than 3 min) after entering PACU to departure

06

Study locations

1 site
  • Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine
    Seoul, 120-752, Korea, Republic of
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03343002
Lead sponsor
Yonsei University
Responsible party
Sponsor
First posted
Nov 17, 2017
Start date
Nov 26, 2017
Primary completion
Aug 27, 2018
Completion
Aug 27, 2018
Last update
Aug 8, 2019

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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