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Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a

Akihiro Kanaya1, Norifumi Kuratani, Daizoh Satoh

  • 1Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan, canal_village0207@yahoo.co.jp.

Journal of Anesthesia
|June 27, 2013
PubMed

Insights

Propofol anesthesia is safer for children than sevoflurane, significantly reducing the risk of emergence agitation (EA). This meta-analysis confirms propofol as the preferred anesthetic agent for pediatric patients, minimizing post-anesthetic complications.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Emergence agitation (EA) is a known adverse effect associated with sevoflurane in pediatric patients.
  • Understanding the comparative incidence of EA between sevoflurane and propofol is crucial for optimizing anesthetic care.

Purpose of the Study:

  • To conduct a meta-analysis of randomized controlled trials comparing the incidence of emergence agitation in children receiving sevoflurane versus propofol anesthesia.
  • To provide evidence-based recommendations for anesthetic agent selection in pediatric populations.

Main Methods:

  • A systematic literature search identified relevant prospective randomized trials.
  • Inclusion criteria focused on children under 15 years undergoing anesthesia with either sevoflurane or propofol.
  • Data were pooled using a random effects model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

  • The meta-analysis included 14 studies with 560 patients receiving sevoflurane and 548 receiving propofol.
  • Propofol anesthesia was associated with a significantly lower incidence of EA (OR = 0.25, 95% CI: 0.16-0.39, P = 0.000).
  • Sensitivity analyses confirmed the robustness of these findings across various study parameters.

Conclusions:

  • Propofol anesthesia is associated with a reduced likelihood of emergence agitation in children compared to sevoflurane.
  • These findings support the use of propofol for minimizing EA in pediatric anesthesia.
  • Further research may explore specific patient subgroups or procedural factors influencing EA incidence.
Abstract

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