The effects of alfentanil on emergence agitation in children under general anesthesia: a meta-analysis of randomized controlled trials
Abstract
Background: Emergence agitation (EA) is characterized by excessive reactivity and sensory impairment that occurs in children after general anesthesia. Alfentanil is a µ-opioid receptor with rapid onset and short duration, widely used in minor surgery. The aim of this meta-analysis is to assess the effect of alfentanil on the incidence of EA in children undergoing general anesthesia.
Methods: PubMed, Cochrane Library, Embase, and Web of Science databases were reviewed to search for related trials published before April 30, 2025. The primary outcome was the incidence of EA. Secondary outcomes included rescue analgesia, postoperative nausea and vomiting (PONV), emergence time, extubation time, and time to discharge from post-anesthesia care unit (PACU).
Results: The study extracted from 5 studies including 532 patients. Compared to saline, alfentanil reduced the incidence of EA in children (RR = 0.54; 95% CI: 0.42-0.70; P P P = 0.37). According to the GRADE system, the quality of evidence was moderate for the incidence of EA.
Conclusions: Limited available evidence suggests that alfentanil is associated with a lower incidence of EA in children. However, further high-quality studies are needed to verify the effect of alfentanil in preventing the occurrence of EA in children undergoing general anesthesia.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023448260, PROSPERO CRD42023448260.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 532 participants or records.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.