Related Experiment Video
Updated: May 22, 2025
Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
Comparing different administration methods of subanaesthetic propofol to mitigate emergence agitation in preschool
Jiaxiang Chen1,2, Xiaoli Shi3, Wei Hu3,4
1Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Insights
Continuous infusion of propofol effectively reduced emergence agitation in preschool children after sevoflurane anesthesia. This method proved more effective than bolus injections without increasing wake-up time.
Area of Science:
- Anesthesiology
- Pediatric Surgery
Background:
- Sevoflurane anesthesia in preschool children is linked to high rates of emergence agitation (EA).
- Subanesthetic doses of propofol can mitigate EA in pediatric patients post-inhalational anesthesia.
- Optimal administration strategies for propofol to prevent EA require further investigation.
Purpose of the Study:
- To evaluate the efficacy of different administration methods of subanesthetic propofol doses in preventing emergence agitation in preschool children.
- To compare the incidence and severity of emergence agitation between continuous propofol infusion and bolus administration.
- To assess the impact of propofol administration on extubation and emergence times.
Main Methods:
- A double-blind trial involving 160 preschool children (2-5 years old) undergoing laparoscopic inguinal hernia repair under sevoflurane anesthesia.
- Participants were randomized into four groups: control, single propofol bolus 3 minutes before surgery end, single bolus at surgery end, and continuous infusion for 3 minutes at surgery end (all 1 mg/kg).
- Emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) and Watcha scales.
Main Results:
- The incidence of emergence agitation was significantly lower in the continuous infusion group (5.0%) compared to the control (65.0%), bolus A (30.0%), and bolus B (32.5%) groups.
- The continuous infusion group exhibited significantly lower peak PAED scores.
- No significant differences in extubation time or emergence time were observed among the groups.
Conclusions:
- Continuous infusion of a subanesthetic dose of propofol (1 mg/kg) for 3 minutes at the conclusion of sevoflurane anesthesia is more effective in reducing emergence agitation.
- This administration method is preferable to bolus injections as it effectively manages EA without prolonging patient emergence.
- The findings support continuous propofol infusion as an optimal strategy for preventing emergence agitation in pediatric patients.
Background:
Preschool children who received sevoflurane anaesthesia were associated with a high incidence of emergence agitation (EA). Studies have shown that a subanaesthetic dose of propofol (1 mg/kg) at the end of inhalational anaesthesia could reduce EA in paediatric patients, but the optimal administrations are still under investigation.
Methods:
In a double-blind trial, 160 preschool children (ASA I or II, 2-5 years old) undergoing day surgery of laparoscopic inguinal hernia repair with sevoflurane anaesthesia were randomly assigned into four groups: the control group, single bolus 3 min before the end of the surgery (bolus A), single bolus at the end of the surgery (bolus B) and continuous infusion for 3 min at the end of the surgery (continuous infusion). The dose of propofol in the bolus A group, bolus B group and continued infusion group is 1 mg/kg. The primary outcomes were the incidence and severity of EA assessed by the Paediatric Anaesthesia Emergence Delirium (PAED) scale and Watcha scales. The secondary outcomes included extubation time, emergence time, mean arterial pressure and heart rate.
Results:
The incidence of EA was as follows: 65.0% in the control group, 30.0% in the bolus A group, 32.5% in the bolus B group and 5.0% in the continuous infusion group (p<0.05). Furthermore, the peak PAED scores in the continuous infusion group were significantly lower than those in the other groups. However, extubation time and emergence time showed no differences among groups.
Conclusions:
Continuous infusion of subanaesthetic dose propofol (1 mg/kg) for 3 min at the end of sevoflurane anaesthesia seems to be more appropriate than other administration as it reduced EA and did not prolong the time to wake.
Trail Registration Number:
NCT05420402.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:22Stages of General Anesthesia
01:20Inhalational Anesthetics: Overview
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:18Drug Delivery: Enteral Route