A Comparative Study of Emergence Agitation between Sevoflurane and Desflurane Anesthesia in Children

Choi, Won Seok; Kim, Mi Woon

Abstract

BACKGROUND: Inhalation anesthesia has been widely used since it has easier administration and excretion through the lung and also provides immediate measurement and alteration of the anesthetic depth. Sevoflurane and desflurane are currently used widely with rapid awakening each with 0.66 and 0.42 blood/gas partition coefficients compared to the existing anesthetics. However, there has been a report that both anaesthetics may show emergence agitation in children. Therefore, we compared the degree of emergence agitation between the sevoflurane and desflurane anesthesia in children.
METHODS
Out of 60 patients who are between 2-12 years of age and belonged to American anesthesiology society grade I, of which scheduled for general anesthesia, we selected and randomized two groups each with S group (using sevoflurane) and the D group (using desflurane). During the anesthesia, sevoflurane was administered as 2.0-2.5 vol% and desflurane with 4.0-7.0 vol%, of which controlled according to the vital sign, and N2O:O2 was applied as 1.5 L:1.5 L in both groups. After the operation, anaesthetics were stopped, and the patient was carried to the recovery room after confirming that the patient was in a stable condition with the prompt recording of the time of spontaneous breathing, which was followed by extubation. Recovery time was recorded by the anesthesiologist until it has reached the score of 6, and classified the degree of agitation in the score of 1 through 5, which was then regarded as emergence agitation when score was above 4. All results were used with average +/- standard deviation or the frequency rate (%). Chi-square test and unpaired t-test were used for the comparison of the two groups, with the results statistically significant when P values are less than 0.05.
RESULTS
No significant differences between the age, weight, sex and the duration of operation in the two groups were noted. Moreover, agitation score was each with 3.00 +/- 0.98 (S group), 2.87 +/- 1.01 (D group), and the emergence agitation frequency with 26.7% (S group), 20.0% (D group), but with no significant differences. However, in the case of recovery time, D group showed significantly faster time than the S group, each with 6.67 +/- 2.59 and 8.67 +/- 2.26 (P < 0.05).
CONCLUSIONS
Both sevoflurane and desflurane revealed rapid awakening period among patients, with little faster in desflurane compared to the sevoflurane. No significant difference in emergence agitation was noted in both anesthetics. More research and consideration of the emergence agitation in children may provide better anesthesiological environment for administering the above two anesthetics.