Journal: Anesthesiology 107(5):733-738, 2007. 27 References
Reprint: Dept of Anesthesiology, American University of Beirut Medical Center, PO Box 11 0236, Beirut, Lebanon (MT Aouad, MD)
Faculty Disclosure: Abstracted by S. Ouellette, who has nothing to disclose.
The occurrence of emergence agitation in children after sevoflurane anesthesia is common, with an incidence of 10-80%. Drugs such as non-opioid analgesics, opioids, benzodiazepines, intravenous anesthetics, and alpha-2 agonists have been used with variable success to allow a smooth emergence from sevoflurane. Avoiding sevoflurane and using a propofol based anesthetic allows for a smoother recovery. Among all inhalation anesthetics, sevoflurane is considered the agent of choice for induction and maintenance of anesthesia in children. The purpose of this study was to compare the incidence and severity of emergence agitation in children who received a single dose of propofol at the end of strabismus surgery versus children who received saline.
Eighty healthy children aged 2-6 yr were studied. The children were randomly allocated to the propofol group (n=41), which received 1 mg/kg propofol at the end of surgery, or to the saline group (n=39). The mean scores on the Pediatric Anesthesia Emergence Delirium scale were significantly lower in the propofol group compared with the saline group. The incidence of agitation was significantly lower in the propofol group compared with the saline group. Times to removal of the laryngeal mask airway and emergence times were significantly longer in the propofol group. However, discharge times were similar between groups. More parents in the propofol group were satisfied.
In children undergoing strabismus surgery, propofol 1 mg/kg at the end of surgery after discontinuation of sevoflurane anesthesia decreases the incidence of agitation and improves parent's satisfaction without delaying discharge from the postanesthesia care unit. |
