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Effectiveness of Intravenous Ibuprofen on Emergence Agitation in Children Undergoing Tonsillectomy with Propofol and

Zhengzheng Gao1, Jianmin Zhang1, Xiaolu Nie2

  • 1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.

Journal of Pain Research
|May 20, 2022
PubMed

Insights

Intravenous ibuprofen significantly reduced emergence agitation (EA) in children undergoing tonsillectomy. This intervention also lowered pain scores and the need for rescue analgesia, improving recovery from general anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Emergence agitation (EA) negatively impacts pediatric recovery from general anesthesia.
  • This study evaluated intravenous ibuprofen's efficacy in mitigating EA incidence in children.

Observation:

  • A randomized, double-blind, placebo-controlled trial involved 89 children aged 3-9 years undergoing tonsillectomy.
  • Participants received either ibuprofen or placebo intraoperatively during general anesthesia with propofol and remifentanil.

Findings:

  • Ibuprofen significantly decreased EA incidence at 15 minutes post-extubation (8.9% vs. 34.1%, P=0.004).
  • The ibuprofen group required fewer rescue fentanyl doses (P=0.045) and reported less moderate to severe pain (P=0.048).
  • High modified Pediatric Anesthesia Behavior and pain scores were risk factors for EA, while ibuprofen was a protective factor.

Implications:

  • Intraoperative ibuprofen administration is an effective strategy to reduce emergence agitation in pediatric patients.
  • This finding supports ibuprofen as a valuable adjunct for improving post-anesthesia recovery in children.
  • Further research may explore ibuprofen's role in other pediatric surgical procedures associated with EA.
Abstract

Keywords:
childrenemergence agitationgeneral anesthesiaibuprofenprotective factor

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