Effects of Remifentanil Administration on Emergence Delirium After Dental Surgery in Children: A Retrospective Study

Introduction: This study aims to compare the incidence of emergency delirium in children who underwent dental rehabilitation under either sevoflurane anesthesia or remifentanil infusion-added sevoflurane anesthesia. Methods: This retrospective study evaluated patients scheduled for dental treatment under general anesthesia between April to September 2019 in a tertiary hospital. Patients were categorized into two groups receiving sevoflurane (group S) or remifentanil infusion and sevoflurane (group R). Emergence delirium and postoperative pain were evaluated by the Paediatric Anesthesia Emergence Delirium scale and The Face, Legs, Activity, Cry, Controllability scale every 10 min. The extubation time, postanesthetic care unit discharge time, duration of surgery, and anesthesia were also recorded. Results: Data from 80 subjects were analyzed. The incidence of emergency delirium was higher in group S than in Group R (67.5%, 27/40; P < 0.001). Greater Paediatric Anesthesia Emergence Delirium (10.2 ± 1.1 / 8.25 ± 1.4; P < 0.001) and The Face, Legs, Activity, Cry, Controllability scale (3.10 ± 0.9 / 2, 03 ± 1.2; P < 0.001) scores were observed in group S than group R. A longer extubation time and shorter postanesthetic care unit discharge time were observed in group R than in group S (P < 0.001). Conclusions: A lower incidence of emergency delirium was observed after remifentanil infusion was added to sevoflurane in children after dental treatment under general anesthesia. Moreover, remifentanil resulted in a more comfortable postoperative period due to reduced postoperative pain, extubation, and recovery time. © 2025, Nepal Paediatric Society (NEPAS). All rights reserved.