Effects of Low-dose Propofol or Ketamine on Coughing at Emergence from Anesthesia in Children Undergoing...

Area of Science:

• Anesthesiology
• Pediatric Surgery

Background:

• Coughing during emergence from general anesthesia is common in children.
• Smooth emergence is particularly important after tonsillectomy procedures.

Purpose of the Study:

• To compare the efficacy of low-dose ketamine versus propofol in mitigating emergence coughing in pediatric tonsillectomy patients.
• To evaluate the impact of these agents on postoperative sedation, nausea, vomiting, and pain.

Main Methods:

• A randomized clinical trial involving 90 children undergoing tonsillectomy.
• Patients were assigned to receive either 0.5 mg/kg propofol or 0.5 mg/kg ketamine at the conclusion of anesthesia.
• Outcomes measured included cough incidence and severity, sedation, nausea, vomiting, and pain scores.

Main Results:

• The incidence of no cough upon emergence was significantly higher in the propofol group (82.2%) compared to the ketamine group (15.5%) (P = 0.00).
• The propofol group experienced a lower incidence of postoperative nausea and vomiting (P < 0.05).
• While ketamine group showed more sedation, both groups had comparable pain scores (P > 0.05).

Conclusions:

• Low-dose propofol (0.5 mg/kg) is more effective than ketamine (0.5 mg/kg) in reducing emergence coughing after isoflurane general anesthesia in pediatric tonsillectomy.
• Propofol also demonstrated benefits in reducing postoperative nausea, vomiting, and sedation levels.