Related Experiment Video
Updated: May 10, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Prevention of sevoflurane delirium and agitation with propofol
1University of Illinois at Chicago, Chicago, Illinois, USA. messieha@uic.edu
Insights
Emergence delirium and agitation (EAD) in children receiving sevoflurane anesthesia is common. A novel Bispectral Index System (BIS)-guided propofol washout technique effectively prevents EAD, improving patient safety and satisfaction.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Neuroscience
Background:
- Emergence delirium and agitation (EAD) are frequent complications in pediatric patients undergoing sevoflurane anesthesia.
- These events increase the risk of injury and reduce parental satisfaction, particularly in outpatient settings.
Purpose of the Study:
- To review existing literature on EAD prevention strategies in children.
- To propose and evaluate a novel Bispectral Index System (BIS)-guided anesthesia technique with propofol washout for EAD prevention.
Main Methods:
- Literature review of EAD management strategies.
- Proposal of a Bispectral Index System (BIS)-guided anesthesia protocol utilizing propofol washout.
Main Results:
- Sevoflurane anesthesia commonly causes EAD in pediatric patients.
- The proposed BIS-guided propofol washout technique is presented as a potentially effective method for EAD prevention.
Conclusions:
- EAD is a significant concern in pediatric anesthesia.
- A BIS-guided propofol washout technique offers a promising approach to mitigate EAD, enhancing safety and satisfaction.
Abstract:
Emergence delirium and agitation (EAD) associated with sevoflurane general anesthesia are very commonly observed in young children. Such events pose a risk for injury as well as decreased parental satisfaction, especially in the ambulatory and office-based setting. This article reviews the different approaches described in the literature to reduce EAD. A novel approach using a Bispectral Index System (BIS)-guided anesthesia with propofol washout technique is proposed as a viable and effective approach to prevent EAD.
Related Concept Videos
Parenteral Anesthetics: Overview
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Inhalational Anesthetics: Overview
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedatives and Hypnotics Drugs: Barbiturates