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Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy

Idress Ali1,2,3, Murad Alahdal4,5, Haifa Xia1,2

  • 1Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

The Libyan Journal of Medicine
|November 28, 2019
PubMed

Insights

Ketofol (1:3) significantly reduced emergence agitation (EA) in children undergoing adenotonsillectomy compared to a control group. This anesthetic combination improved recovery profiles and showed no adverse events, making it a safer option for pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery

Background:

  • Emergence agitation (EA) is a common complication following general anesthesia in children.
  • Adenotonsillectomy is a frequent pediatric surgical procedure associated with postoperative pain and agitation.
  • Evaluating novel anesthetic combinations is crucial for improving pediatric patient outcomes.

Purpose of the Study:

  • To assess the efficacy of a 1:3 ratio ketofol combination (ketamine and propofol) in mitigating emergence agitation in pediatric patients.
  • To compare the incidence and severity of emergence agitation between ketofol and a control group during adenotonsillectomy.

Main Methods:

  • A randomized controlled trial involving 120 children aged 3-15 years undergoing adenotonsillectomy.
  • One group received ketofol (1:3 ratio) 10 minutes before surgery end, while the control group received saline and dextrose.
  • Anesthesia was maintained with sevoflurane; emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.

Main Results:

  • Ketofol significantly reduced the incidence (13.33% vs. 48.33%) and severity of emergence agitation compared to the control group (P < 0.05).
  • Patients in the ketofol group exhibited shorter recovery times and improved alertness post-anesthesia (P < 0.05).
  • No significant adverse events, including nausea, respiratory depression, or hemodynamic instability, were observed in the ketofol group.

Conclusions:

  • Ketofol (1:3 ratio) is an effective and safe anesthetic agent for reducing postoperative emergence agitation in children undergoing adenotonsillectomy.
  • This anesthetic strategy improves patient recovery profiles and minimizes the risk of adverse events.
  • Ketofol offers a promising alternative for pediatric anesthesia, enhancing patient comfort and safety.

Keywords:
Anesthesiaadenotonsillectomyemergency agitationketaminepropofol

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