{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T17:27:01Z","timestamp":1783186021838,"version":"3.54.6"},"reference-count":45,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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\u2009\u03bcg\/kg) during anesthesia induction could reduce EA following AT surgery for obstructive sleep apnea in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>A total of 186 ASA I\u2013III children aged 3\u20137 years undergoing AT surgery were enrolled in a blinded randomized trial comparing hydromorphone (30\u2009\u03bcg\/kg) to fentanyl (4\u2009\u03bcg\/kg). The primary outcome was EA incidence within 30\u2009min 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u201329.5%;\n                      <jats:italic>P<\/jats:italic>\n                      = 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hydromorphone at 30\u2009\u03bcg\/kg effectively reduces the incidence of EA within 30\u2009min post-extubation in children after AT surgery compared to fentanyl. It shows superior analgesia and has a low incidence of adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2024-1129","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T08:41:00Z","timestamp":1738917660000},"source":"Crossref","is-referenced-by-count":2,"title":["Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study"],"prefix":"10.1515","volume":"20","author":[{"given":"Qiyuan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operation Center, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University , Chengdu , Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwei","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu , 610041, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"2025122201303439056_j_med-2024-1129_ref_001","doi-asserted-by":"crossref","unstructured":"Clements AC, Walsh JM, Dai X, Skinner ML, Sterni LM, Tunkel DE, et al. 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