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Propofol reduces the incidence of emergence agitation in preschool-aged children as well as in school-aged children: a comparison with sevoflurane

Abstract

Purpose

Young age is considered as one of the factors associated with emergence agitation (EA) following sevoflurane anesthesia. The relationship between EA following propofol anesthesia and young age has not yet been examined. This study was designed to compare the incidence of EA in younger children and older children following either propofol or sevoflurane anesthesia.

Methods

Ninety-six preschool-aged (2–5 years) children and 90 school-aged (6–11 years) children (American Society of Anesthesiologists [ASA] I or II) scheduled to undergo otorhinolaryngological surgery were randomly assigned to receive either propofol or sevoflurane. These children were divided into the following four groups: propofol-preschool (P-pre), sevoflurane-preschool (S-pre), propofol-school (P-school), and sevoflurane-school (S-school) groups. Recovery times and incidence of EA were compared among the four groups.

Results

We observed that the recovery times were similar in the four groups. After extubation, the incidence of EA in the S-pre group was significantly higher than that in the other groups. After eye opening, the incidence of EA in the S-pre and S-school groups was significantly higher than that in the P-pre or P-school groups. At all recovery times, no difference was observed in the incidence of EA between the P-pre and P-school groups.

Conclusion

Propofol, in comparison with sevoflurane, resulted in a lower incidence of EA, with no relation to age.

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References

  1. J Aono W Ueda K Mamiya E Takimoto M Manabe (1997) ArticleTitleGreater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys Anesthesiology 87 1298–1300 Occurrence Handle9416712 Occurrence Handle10.1097/00000542-199712000-00006 Occurrence Handle1:STN:280:DyaK1c%2FnslWqtg%3D%3D

    PubMed  Article  CAS  Google Scholar 

  2. T Voepel-Lewis S Malviya AR Tait (2003) ArticleTitleA prospective cohort study of emergence agitation in the pediatric postanesthesia care unit Anesth Analg 96 1625–1630 Occurrence Handle12760985 Occurrence Handle10.1213/01.ANE.0000062522.21048.61

    PubMed  Article  Google Scholar 

  3. IT Cohen JC Finkel RS Hannallah KA Hummer KM Patel (2003) ArticleTitleRapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol Paediatr Anaesth 13 63–67 Occurrence Handle12535042 Occurrence Handle10.1046/j.1460-9592.2003.00948.x

    PubMed  Article  Google Scholar 

  4. V Picard L Dumont M Pellegrini (2000) ArticleTitleQuality of recovery in children: sevoflurane versus propofol Acta Anaesthesiol Scand 44 307–310 Occurrence Handle10714845 Occurrence Handle10.1034/j.1399-6576.2000.440315.x Occurrence Handle1:CAS:528:DC%2BD3cXivFeksbc%3D

    PubMed  Article  CAS  Google Scholar 

  5. S Uezono T Goto K Terui F Ichinose Y Ishiguro Y Nakata S Morita (2000) ArticleTitleEmergence agitation after sevoflurane versus propofol in pediatric patients Anesth Analg 91 563–566 Occurrence Handle10960377 Occurrence Handle10.1097/00000539-200009000-00012 Occurrence Handle1:CAS:528:DC%2BD3cXmslWmt70%3D

    PubMed  Article  CAS  Google Scholar 

  6. J Lerman PJ Davis LG Welborn RJ Orr M Rabb R Carpenter E Motoyama R Hannallah CM Haberkern (1996) ArticleTitleInduction, recovery, and safety characteristics of sevoflurane in children undergoing ambulatory surgery: a comparison with halothane Anesthesiology 84 1332–1340 Occurrence Handle8669674 Occurrence Handle10.1097/00000542-199606000-00009 Occurrence Handle1:CAS:528:DyaK28Xkt1ems7s%3D

    PubMed  Article  CAS  Google Scholar 

  7. LG Welborn RS Hannallah JM Norden UE Ruttimann CM Callan (1996) ArticleTitleComparison of emergence and recovery characteristics of sevoflurane, desflurane, and halothane in pediatric ambulatory patients Anesth Analg 83 917–920 Occurrence Handle8895263 Occurrence Handle10.1097/00000539-199611000-00005 Occurrence Handle1:CAS:528:DyaK28XntV2gtbw%3D

    PubMed  Article  CAS  Google Scholar 

  8. A Beskow P Westrin (1999) ArticleTitleSevoflurane causes more postoperative agitation in children than does halothane Acta Anaesthesiol Scand 43 536–541 Occurrence Handle10342001 Occurrence Handle10.1034/j.1399-6576.1999.430508.x Occurrence Handle1:CAS:528:DyaK1MXjslClsLk%3D

    PubMed  Article  CAS  Google Scholar 

  9. LT Wells DK Rasch (1999) ArticleTitleEmergence “delirium” after sevoflurane anesthesia: a paranoid delusion? Anesth Analg 88 1308–1310 Occurrence Handle10357335 Occurrence Handle10.1097/00000539-199906000-00020 Occurrence Handle1:STN:280:DyaK1M3osVahtQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  10. PJ Davis JA Greenberg M Gendelman K Fertal (1999) ArticleTitleRecovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringotomy and pressure equalization tube insertion Anesth Analg 88 34–38 Occurrence Handle9895062 Occurrence Handle10.1097/00000539-199901000-00007 Occurrence Handle1:CAS:528:DyaK1MXmtVerug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  11. JL Galinkin LM Fazi RM Cuy RM Chiavacci CD Kurth UK Shah IN Jacobs MF Watcha (2000) ArticleTitleUse of intranasal fentanyl in children undergoing myringotomy and tube placement during halothane and sevoflurane anesthesia Anesthesiology 93 1375–1383 Occurrence Handle10.1097/00000542-200012000-00006

    Article  Google Scholar 

  12. SL Lapin SM Auden LJ Goldsmith AM Reynolds (1999) ArticleTitleEffect of sevoflurane anaesthesia on recovery in children: a comparison with halothane Paediatr Anaesth 9 299–304 Occurrence Handle10411764 Occurrence Handle10.1046/j.1460-9592.1999.00351.x Occurrence Handle1:STN:280:DyaK1MzktVejug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  13. I Constant MC Dubois V Piat ML Moutard M McCue I Murat (1999) ArticleTitleChanges in electroencephalogram and autonomic cardiovascular activity during induction of anesthesia with sevoflurane compared with halothane in children Anesthesiology 91 1604–1615 Occurrence Handle10598600 Occurrence Handle10.1097/00000542-199912000-00010 Occurrence Handle1:CAS:528:DC%2BD3cXivFKhtQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  14. H Viitanen P Tarkkila S Mennander M Viitanen P Annila (1999) ArticleTitleSevoflurane-maintained anesthesia induced with propofol or sevoflurane in small children: induction and recovery characteristics Can J Anaesth 46 21–28 Occurrence Handle10078398 Occurrence Handle1:STN:280:DyaK1M7nvVWhtg%3D%3D Occurrence Handle10.1007/BF03012509

    PubMed  CAS  Article  Google Scholar 

  15. PM De Grood LG Coenen J van Egmond LH Booij JF Crul (1987) ArticleTitlePropofol emulsion for induction and maintenance of anaesthesia. A combined technique of general and regional anaesthesia Acta Anaesthesiol Scand 31 219–223 Occurrence Handle3495089 Occurrence Handle1:STN:280:DyaL2s3gvVyrtA%3D%3D Occurrence Handle10.1111/j.1399-6576.1987.tb02554.x

    PubMed  CAS  Article  Google Scholar 

  16. RF Mortero LD Clark MM Tolan RJ Metz K Tsueda RA Sheppard (2001) ArticleTitleThe effects of small-dose ketamine on propofol sedation: respiration, postoperative mood, perception, cognition, and pain Anesth Analg 92 1465–1469 Occurrence Handle11375826 Occurrence Handle10.1097/00000539-200106000-00022 Occurrence Handle1:CAS:528:DC%2BD3MXksVyht7g%3D

    PubMed  Article  CAS  Google Scholar 

  17. IT Cohen JC Finkel RS Hannallah KA Hummer KM Patel (2002) ArticleTitleThe effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children Anesth Analg 94 1178–1181 Occurrence Handle11973185 Occurrence Handle10.1097/00000539-200205000-00023 Occurrence Handle1:CAS:528:DC%2BD38XktVSnurg%3D

    PubMed  Article  CAS  Google Scholar 

  18. A Kararmaz S Kaya S Turhanoglu MA Ozyilmaz (2004) ArticleTitleOral ketamine premedication can prevent emergence agitation in children after desflurane anaesthesia Paediatr Anaesth 14 477–482 Occurrence Handle15153210 Occurrence Handle10.1111/j.1460-9592.2004.01224.x

    PubMed  Article  Google Scholar 

  19. JB Rose MF Watcha (1999) ArticleTitlePostoperative nausea and vomiting in pediatric patients Br J Anaesth 83 104–117 Occurrence Handle10616338 Occurrence Handle1:STN:280:DC%2BD3c%2FotlOisw%3D%3D

    PubMed  CAS  Google Scholar 

  20. JK Moore EW Moore RA Elliott AS St Leger K Payne J Kerr (2003) ArticleTitlePropofol and halothane versus sevoflurane in paediatric day-case surgery: induction and recovery characteristics Br J Anaesth 90 461–466 Occurrence Handle12644418 Occurrence Handle10.1093/bja/aeg098 Occurrence Handle1:CAS:528:DC%2BD3sXjsFSqu7o%3D

    PubMed  Article  CAS  Google Scholar 

  21. Y Gurkan L Kilickan K Toker (1999) ArticleTitlePropofol-nitrous oxide versus sevoflurane-nitrous oxide for strabismus surgery in children Paediatr Anaesth 9 495–499 Occurrence Handle10597552 Occurrence Handle10.1046/j.1460-9592.1999.00399.x Occurrence Handle1:STN:280:DC%2BD3c%2FmsFChsg%3D%3D

    PubMed  Article  CAS  Google Scholar 

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Nakayama, S., Furukawa, H. & Yanai, H. Propofol reduces the incidence of emergence agitation in preschool-aged children as well as in school-aged children: a comparison with sevoflurane. J Anesth 21, 19–23 (2007). https://doi.org/10.1007/s00540-006-0466-x

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  • DOI: https://doi.org/10.1007/s00540-006-0466-x

Key words

  • Emergence agitation
  • Sevoflurane
  • Propofol
  • Children
  • Age