Korean J Anesthesiol.  2019 Jun;72(3):253-259. 10.4097/kja.d.18.00345.

Three minutes propofol after sevoflurane anesthesia to prevent emergence agitation following inguinal hernia repair in children: a randomized controlled trial

• Abbas MS
• El-Hakeem
• Kamel HE

• KMID: 2454884
• DOI: http://doi.org/10.4097/kja.d.18.00345

Abstract

BACKGROUND
Emergence agitation (EA) is a common problem after sevoflurane anesthesia among children. There have been mixed results with control of EA using propofol 1 mg/kg bolus following sevoflurane anesthesia. An infusion of 3 mg/kg of propofol over 3 min following sevoflurane anesthesia has been found to be promising in children undergoing magnetic resonance imaging scans. However, no studies have been conducted during surgical procedures. We aimed to examine the efficacy of transition to propofol for 3 min after cessation of sevoflurane anesthesia in children undergoing inguinal hernia repair.
METHODS
In this prospective randomized controlled trial, 64 children aged 1-12 years, scheduled for inguinal hernia repair, were randomized to receive either propofol 3 mg/kg over 3 min (propofol group) or no propofol (control group), after the cessation of sevoflurane anesthesia. EA was assessed using the Paediatric Emergence Anesthesia Delirium (PAED) scale and the Watcha scale. Emergence time and the duration of post-anesthesia care unit (PACU) stay were also recorded.
RESULTS
The incidence of ED was lower in the propofol group on both the PAED (81.3% vs. 15.6%, P < 0.001) and the Watcha (78.1% vs. 15.6%, P < 0.001) scales. The mean emergence time was 6.37 minutes longer in the propofol group with no significant difference in PACU times.
CONCLUSIONS
Transition to propofol 3 mg/kg over 3 min following sevoflurane anesthesia reduces the incidence of EA and improves the quality of emergence. Although emergence times were longer, the duration of stay in the PACU was similar with propofol use.

Keyword

Agitation; Delirium; Emergence; Pediatrics; Propofol; Sevoflurane

MeSH Terms

Anesthesia*
Child*
Delirium
Dihydroergotamine*
Hernia, Inguinal*
Humans
Incidence
Magnetic Resonance Imaging
Pediatrics
Propofol*
Prospective Studies
Weights and Measures
Dihydroergotamine
Propofol