Related Experiment Video

Updated: Aug 13, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Barbiturate Induction for the Prevention of Emergence Agitation after Pediatric Sevoflurane Anesthesia

Tadasuke Use1, Haruna Nakahara1, Ayako Kimoto1

  • 1Department of Anesthesiology, Sasebo Kyosai Hospital, Sasebo, Japan.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|October 17, 2015
PubMed

Insights

Thiamylal induction significantly reduced emergence agitation in pediatric patients after sevoflurane anesthesia. This intravenous barbiturate offers a promising approach to managing post-anesthetic complications in children.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Emergence agitation (EA) is a frequent complication in pediatric patients post-anesthesia.
  • Sevoflurane anesthesia is associated with a higher incidence of EA.
  • Effective strategies to mitigate EA are crucial for pediatric post-operative care.

Purpose of the Study:

  • To evaluate the efficacy of intravenous thiamylal for induction in reducing EA.
  • To compare the incidence and severity of EA between thiamylal and sevoflurane induction.
  • To assess the impact of thiamylal on pediatric patients recovering from sevoflurane anesthesia.

Main Methods:

  • Prospective, randomized, double-blind study involving 54 pediatric patients (1-6 years).
  • Two induction groups: intravenous thiamylal 5mg/kg (Group T) vs. inhalational sevoflurane 5% (Group S).
  • Anesthesia maintained with sevoflurane and N2O; pain managed with caudal or ilioinguinal blocks. EA assessed using the Modified Objective Pain Scale (MOPS).

Main Results:

  • Fifteen minutes post-PACU arrival, EA incidence was significantly lower in Group T (28%) vs. Group S (64%; p=0.023).
  • MOPS scores were significantly lower in Group T (median 0) compared to Group S (median 4; p=0.005).
  • No significant difference in emergence time between groups.

Conclusions:

  • Intravenous thiamylal induction effectively reduces the incidence and severity of emergence agitation.
  • Thiamylal is a viable option for pediatric anesthesia induction to improve recovery quality after sevoflurane anesthesia.
  • This study supports thiamylal's role in managing post-anesthetic agitation in children.
Abstract

Keywords:
Sevofluraneanesthesia recovery periodpediatricspsychomotor agitationthiamylal

More Related Videos

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits06:46

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits

Published on: February 28, 2025

Application of Dixon's Up-and-Down Design to Estimate the Minimum Alveolar Concentration of Sevoflurane in Rats with Refined Movement Classification03:02

Application of Dixon's Up-and-Down Design to Estimate the Minimum Alveolar Concentration of Sevoflurane in Rats with Refined Movement Classification

Published on: July 25, 2025

Related Concept Videos

Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A key...
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
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...