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[Effect of propofol on sevoflurane agitation in children]
Satoko Chiba1, Takeshi Shima, Noritaka Murakami
1Division of Anesthesia, Japanese Red Cross Sendai Hospital, Sendai 980-8501.
Insights
Bolus propofol administration after sevoflurane anesthesia did not reduce emergence agitation in children. Recovery time was prolonged in the propofol groups compared to the control group.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Sevoflurane anesthesia in children is frequently linked to agitation during emergence from anesthesia.
- Investigating interventions to mitigate sevoflurane-induced emergence agitation is clinically significant.
Purpose of the Study:
- To evaluate the efficacy of bolus propofol administration in reducing recovery agitation following sevoflurane anesthesia in pediatric patients.
- To compare the speed and quality of recovery between propofol and control groups.
Main Methods:
- A randomized, double-blinded study involving 90 children aged 1-7 years undergoing short general anesthesia.
- Three groups were established: propofol 2 mg/kg (P2), propofol 1 mg/kg (P1), and intralipid control (C).
- Propofol or intralipid was administered 5 minutes before the end of sevoflurane anesthesia; recovery was assessed using a novel scoring system.
Main Results:
- No significant difference in recovery agitation scores was observed among the propofol (P2, P1) and control (C) groups.
- Recovery time was significantly prolonged by approximately 6 minutes in the high-dose propofol group (P2) compared to the control group (C).
Conclusions:
- Bolus administration of propofol following sevoflurane anesthesia does not effectively inhibit emergence agitation in children.
- Propofol administration prolongs the recovery time without providing a benefit in reducing sevoflurane-associated agitation.
Background:
Sevoflurane may be associated with a high incidence of agitation during recovery from anesthesia in children. We tested the hypothesis that bolus administration of propofol after sevoflurane anesthesia would reduce the incidence of recovery agitation compared with sevoflurane anesthesia alone.
Methods:
We conducted a randomized, double-blinded study in 90 children, 1-7 yr of age, undergoing short general anesthesia. They were divided into three groups; 2 mg.kg-1 propofol (group P2), 1 mg.kg-1 propofol (group P1) and intralipid 0.2 ml.kg-1 as control (group C). After sevoflurane induction and maintenance and 5 minutes before the end of operation, propofol or intralipid was administered. We compared the speed and quality of each recovery. We made a new scoring system for the assessment of agitation. Each child received a point from -4 to 10 with this system.
Results:
Recovery score was similar among the three groups (group P2 had point 4, group P1, point 5, and group C point 4). Recovery time in group P2 was significantly longer than that in group C (about 6 minutes).
Conclusions:
Bolus administration of propofol after sevoflurane anesthesia prolonged recovery time, but did not inhibit sevoflurane agitation compared with sevoflurane anesthesia alone.