Comparison of the anesthetic effect of sufentanil versus fentanyl in pediatric surgical patients: a meta-analysis

Abstract

Objective: To evaluate the anesthetic effects of sufentanil and fentanyl in pediatric surgery.

Methods: We conducted a comprehensive search across multiple databases, including Wanfang, CNKI, Chinese Biomedical Literature, VIP, Embase, PubMed, Cochrane Library, and Web of Science. Studies were retrieved to screen randomized controlled trials (RCTs) comparing sufentanil and fentanyl use in children during surgery. Primary outcomes included mean arterial pressure (MAP), heart rate (HR), Ramsay sedation score, and restlessness score (RS). Pooled and sensitivity analyses were performed, and risk of bias was assessed.

Results: Fourteen studies compared the efficacy of sufentanil and fentanyl in terms of MAP immediately after intubation. The results demonstrated that sufentanil exhibited a more pronounced reduction in MAP compared with fentanyl (SMD: -0.62; 95% CI = [-0.97, -0.27]; I² = 79.6%, P < 0.001). A total of 5 studies compared the efficacy of sufentanil and fentanyl in MAP at five and fifteen minutes after intubation, with sufentanil again showing a more pronounced reduction in MAP compared with fentanyl (P < 0.05). Additionally, sufentanil resulted in a more stable HR compared to fentanyl (SMD: -0.46; 95% CI = -0.58 - -0.33; I² = 53.5%, P < 0.0001). There were 4 studies reporting the effects of sufentanil on RS, indicating that sufentanil led to significantly greater reductions in RS compared to fentanyl (SMD: -1.59; 95% CI = [-2.52, -0.66]; I² = 91.5%, P < 0.001).

Conclusion: Among the children undergoing surgery, sufentanil demonstrates more advantages over fentanyl in maintaining stable hemodynamics and reducing postoperative agitation, offering better clinical benefits.

Keywords: Anesthetic effect; children; fentanyl; meta-analysis; sufentanil; surgery.