BMC pediatrics
Comparison of the efficacy of pentazocine and tramadol for reducing emergence agitation in children after general anesthesia: a retrospective cohort study
By Ren W, Wang B, Han B and 1 others.
Abstract
Background
Emergence agitation (EA) is a common postoperative complication in pediatric anesthesia that can lead to serious safety events and increased healthcare burden. Both pentazocine and tramadol are frequently used for postoperative analgesia in children, but their comparative effectiveness in preventing EA remains unknown. This study aimed to compare the efficacy of a single intravenous dose of tramadol versus pentazocine for reducing EA in children undergoing tonsillectomy and adenoidectomy.
Methods
This single-center retrospective cohort study included 240 children aged 2-12 years who underwent elective tonsillectomy and adenoidectomy under general anesthesia with remimazolam induction. Patients received either pentazocine 0.4 mg/kg or tramadol 1 mg/kg intravenously immediately after surgery. The primary outcome was the incidence of EA, defined as a Pediatric Anesthesia Emergence Delirium (PAED) scale score ≥ 10 at any time during the post-anesthesia care unit (PACU) stay. Secondary outcomes included PAED score trajectories over time, PACU stay duration, postoperative pain (FLACC scale), and adverse events (nausea/vomiting, respiratory depression). Statistical analyses primarily used multivariable logistic regression; secondary and sensitivity analyses (linear mixed models, generalized estimating equations, spline-based models, and Cox regression) were performed to assess robustness and are detailed in the Supplementary Material.