Pediatric anesthesia & critical care
Association of preoperative nocturnal hypoxaemia nadir and fentanyl ventilatory sensitivity in children with obstructive sleep apnoea undergoing general anaesthesia: a multicentre clinical cohort study
Authors' conclusion
Single-dose fentanyl ventilatory effects in paediatric OSA patients during sevoflurane anaesthesia were not associated with preoperative nocturnal hypoxaemia nadir.
Study context
- Population
- Children 2–8 yr with obstructive sleep apnoea (OSA) undergoing adenotonsillectomy; fentanyl (maximum 25 μg) after sevoflurane inductionin-cohort randomisation
- Participants
- 90 children
- Exposure
- Spo2 <85% vs Spo2 ≥85%
- Spo2 <85%n = 47
- Spo2 ≥85%n = 43reference
- Outcome
- Opioid-induced central ventilatory depression by SpO2 status: changes in tidal volume, respiratory rate, end-tidal CO2 and minute ventilation vs pre-fentanyl baseline
- Follow-up
- 10 min after fentanyl
Methodological detailsin-cohort dose randomisation, intention-to-treat and per protocol analysis
- In-cohort dose randomisation
- Intention-to-treat and per protocol analysis
Main finding
As reported in the abstract
Tidal volume, respiratory rate, end-tidal CO2, minute ventilation (% change per minute, baseline to 10 min) · 10 min
- Not different between groups by SpO2 nadir (< or ≥85%) and fentanyl dose (multivariable mixed effect model)
- Intention-to-treat and per protocol analyses
Observational data: associations, not effects.
Original publication
Association of preoperative nocturnal hypoxaemia nadir and fentanyl ventilatory sensitivity in children with obstructive sleep apnoea undergoing general anaesthesia: a multicentre clinical cohort study. Br J Anaesth. Published 5 September 2025. doi:10.
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