{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:29Z","timestamp":1787027069684,"version":"build-2736575974"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergence agitation (EA) is a common complication in the pediatric population. This study aimed to investigate the effect of the prophylactic nalbuphine on EA in pediatric patients receiving sevoflurane anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The children undergoing ear, nose, and throat (ENT) surgery were administered 0.2\u2005mg\/kg nalbuphine (the nalbuphine group) or the same volume of normal saline (the control group) 5\u2005min before the end of the surgery. The extubating time, time to eye-opening and duration of the post-anesthesia care unit (PACU) were recorded. Heart rate and blood pressure were monitored before and 5\u2005min after nalbuphine administration. Pain was assessed using Face Legs Activity Cry and Consolability (FLACC) scales, and the drug-related postoperative complications (e.g., EA, delayed awakening, nausea and vomiting, and respiratory depression) were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One-hundred and thirty pediatric patients were randomly divided into nalbuphine and control groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200965). The nalbuphine group showed a significantly lower incidence of EA than the control group (20% vs. 46.2%,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u20090.002). No significant differences between the two groups were observed in heart rate and blood pressure 5\u2005min after nalbuphine administration (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). No significant differences were observed between the two groups regarding extubating time, time to eye-opening, and duration of PACU. The FLACC scales demonstrated lower values in the nalbuphine group than in the control group during the initial 4\u2005h after the surgery. However, the FLACC scales showed similar values between 5 and 12\u2005h after the surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In summary, the results of this study demonstrated that prophylactic natbuphine could minimize the incidence of EA in pediatric patients following ENT surgery without increasing the extubating time and PACU duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>http:\/\/www.chictr.org.cn<\/jats:uri>\n                      , identifier [ChiCTR2300070046].\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2024.1353027","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T08:29:00Z","timestamp":1726648140000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of prophylactic nalbuphine on emergence agitation and postoperative pain in pediatric patients undergoing ENT surgery with sevoflurane anesthesia"],"prefix":"10.3389","volume":"12","author":[{"given":"Wendong","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjie","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2165\/00128072-199901020-00005","article-title":"Sevoflurane in paediatric anaesthesia: a review","volume":"1","author":"Goa","year":"1999","journal-title":"Paediatr Drugs"},{"key":"B2","first-page":"402","article-title":"Excitation and delirium during sevoflurane anesthesia in pediatric patients","volume":"68","author":"Veyckemans","year":"2002","journal-title":"Minerva Anestesiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1093\/bja\/aew477","article-title":"Pediatric emergence delirium: a comprehensive review and interpretation of the literature","volume":"118","author":"Mason","year":"2017","journal-title":"Br J Anaesth"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.2147\/DDDT.S198123","article-title":"The effect of midazolam administration for the prevention of emergence agitation in pediatric patients with extreme fear and non-cooperation undergoing dental treatment under sevoflurane anesthesia, a double-blind, randomized study","volume":"13","author":"Kawai","year":"2019","journal-title":"Drug Des Devel Ther"},{"key":"B5","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1111\/pan.12669","article-title":"Does a prophylactic dose of propofol reduce emergence agitation in children receiving anesthesia? A systematic review and meta-analysis","volume":"25","author":"van Hoff","year":"2015","journal-title":"Paediatr Anaesth"},{"key":"B6","doi-asserted-by":"publisher","first-page":"177","DOI":"10.4103\/joacp.JOACP_257_19","article-title":"Efficacy of 0.5\u2005mg\/kg of propofol at the end of anesthesia to reduce the incidence of emergence agitation in children undergoing general anesthesia with sevoflurane","volume":"36","author":"Ramlan","year":"2020","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1093\/bja\/aes382","article-title":"Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children","volume":"110","author":"Kim","year":"2013","journal-title":"Br J Anaesth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s00540-015-2098-5","article-title":"Emergence agitation in children: risk factors, prevention, and treatment","volume":"30","author":"Kanaya","year":"2016","journal-title":"J Anesth"},{"key":"B9","doi-asserted-by":"publisher","first-page":"991581","DOI":"10.3389\/fphar.2022.991581","article-title":"Low-dose esketamine for the prevention of emergency agitation in children after tonsillectomy: a randomized controlled study","volume":"13","author":"Li","year":"2022","journal-title":"Front Pharmacol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/AJP.0000000000000211","article-title":"Nalbuphine for treatment of opioid-induced pruritus: a systematic review of literature","volume":"32","author":"Jannuzzi","year":"2016","journal-title":"Clin J Pain"},{"key":"B11","doi-asserted-by":"publisher","first-page":"172702","DOI":"10.1016\/j.ejphar.2019.172702","article-title":"Nalbuphine, a kappa opioid receptor agonist and mu opioid receptor antagonist attenuates pruritus, decreases IL-31, and increases IL-10 in mice with contact dermatitis","volume":"864","author":"Inan","year":"2019","journal-title":"Eur J Pharmacol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"252","DOI":"10.5603\/AIT.2015.0036","article-title":"The use of nalbuphine in paediatric anaesthesia","volume":"47","author":"Kubica-Cieli\u0144ska","year":"2015","journal-title":"Anaesthesiol Intensive Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1002\/ddr.21568","article-title":"Effectiveness of nalbuphine, a \u03ba-opioid receptor agonist and \u03bc-opioid receptor antagonist, in the inhibition of INa, IK(M), and IK(erg) unlinked to interaction with opioid receptors","volume":"80","author":"Liu","year":"2019","journal-title":"Drug Dev Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"658047","DOI":"10.3389\/fped.2021.658047","article-title":"A randomized controlled study of caudal dexmedetomidine for the prevention of postoperative agitation in children undergoing urethroplasty","volume":"29","author":"Zhu","year":"2021","journal-title":"Front Pediatr"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.2147\/JPR.S397064","article-title":"A systematic review of the measurement properties of face, legs, activity, cry and consolability scale for pediatric pain assessment","volume":"16","author":"Peng","year":"2023","journal-title":"J Pain Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1097\/AJP.0000000000000613","article-title":"EC50 of epidural ropivacaine combined with dexmedetomidine for labor analgesia","volume":"34","author":"Zhang","year":"2018","journal-title":"Clin J Pain"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2821","DOI":"10.2147\/JPR.S177122","article-title":"Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial","volume":"11","author":"Zhong","year":"2018","journal-title":"J Pain Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1688450","DOI":"10.1080\/19932820.2019.1688450","article-title":"Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy","volume":"15","author":"Ali","year":"2020","journal-title":"Libyan J Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"111044","DOI":"10.1016\/j.jclinane.2022.111044","article-title":"Nalbuphine reduces the incidence of emergence agitation in children undergoing adenotonsillectomy: a prospective, randomized, double-blind, multicenter study","volume":"85","author":"He","year":"2023","journal-title":"J Clin Anesth"},{"key":"B20","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1038\/clpt.1980.67","article-title":"Ceiling effect for respiratory depression by nalbuphine","volume":"27","author":"Romagnoli","year":"1980","journal-title":"Clin Pharmacol Ther"},{"key":"B21","doi-asserted-by":"publisher","first-page":"184","DOI":"10.4097\/kjae.2017.70.2.184","article-title":"Comparison of single -dose nalbuphine versus tramadol for postoperative pain management in children: a randomized, controlled trial","volume":"70","author":"Liaqat","year":"2017","journal-title":"Korean J Anesthesiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"296","DOI":"10.4103\/1658-354X.115363","article-title":"Prevention of sevoflurane related emergence agitation in children undergoing adenotonsillectomy: a comparison of dexmedetomidine and propofol","volume":"7","author":"Ali","year":"2013","journal-title":"Saudi J Anaesth"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1353027\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T08:29:02Z","timestamp":1726648142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1353027\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,17]]},"references-count":22,"alternative-id":["10.3389\/fped.2024.1353027"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1353027","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,17]]},"article-number":"1353027"}}