Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children

Kim, M.-S.; Moon, B.-E.; Kim, Ha Yong; Lee, Jeong Rim

doi:10.1093/bja/aes382

Cited by 96 publications

(121 citation statements)

References 29 publications

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“…As a result of this, 45 articles published from 1999 to 2015 were complied with the selection criteria (Fig. 1)5678910111213141516171819202122232425262728293031323334353637383940414243444546474849. A total of 4,032 cases were included and the detailed baseline characteristics of the included studies were displayed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Wang

Huang

Gao

et al. 2016

Sci Rep

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Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay. Both traditional and network meta-analysis were carried in this study. A total of 45 articles were complied with the selection criteria and the corresponding articles were reviewed. Fentanyl demonstrated the highest cumulative ranking probability which was followed by those of ketamine and dexmedetomidine with respect to EA and PAED. When PONV and RA were concerned together, clonidine exhibited the highest cumulative ranking probability compared to other medications. Our study suggested that dexmedetomidine perhaps is the most appropriate prophylactic treatment which can be introduced into anesthesia for preventing emergence agitation.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Wang

Huang

Gao

et al. 2016

Sci Rep

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“…Similar to the current study, their findings showed that propofol was more effective in reducing the incidence of EA compared to thiopental sodium. Kim et al (25) indicated that low dosage of propofol or fentanyl can reduce the incidence of sevoflurane-induced agitation. Aouad et al (26) showed the effectiveness of propofol in reduced incidence of sevoflurane-induced EA in children undergoing strabismus surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Hwang et al (24) and Coolong et al (28) indicated that propofol and thiopental sodium do not make significant difference in the incidence of nausea and vomiting in patients. On the other hand, Kim et al (25) showed that propofol causes lower nausea and vomiting in patients compared to fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Appropriate Anesthesia Regimen to Control Sevoflurane-Induced Emergence Agitation in Children: Propofol–Lidocaine and Thiopental Sodium–Lidocaine: A Randomized Controlled Trial

Rahimzadeh¹,

Faiz²,

Alebouyeh³

et al. 2014

Iran Red Crescent Med J

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Background:Emergence Agitation (EA) is a common problem in pediatric anesthesia. The current study evaluated the effect of intravenous lidocaine combined with propofol or thiopental sodium to control EA by sevoflurane in children.Objectives:The current study aimed to compare the effectiveness of two anesthesia regimen propofol–lidocaine and thiopental sodium lidocaine to control sevoflurane-induced emergence agitation in children.Patients and Methods:The study enrolled 120 children aged 12 to 36 months with retinoblastoma who underwent induction of anesthesia with sevoflurane for Eye Examination Under Anesthesia (EUA). Sampling was done at Rasoul-Akram Hospital in Tehran, Iran. The subjects were randomly assigned into four groups including: group one (thiopental sodium-lidocaine [TL]), group two (thiopental sodium-saline [TS]), group three (propofol-lidocaine [PL]), and group four (propofol-saline [PS]). Emergence agitation was assessed by using a five-point scoring scale, every 10 minutes during the first 30 minutes after admission to the recovery room.Results:EA occurred in 24 cases (20%) of children. Incidence of EA in the TS, TL, PS, and PL groups were 21 (70%), 2 (6.7%), 1 (3.3%), and 0 (0%), respectively (P < 0.001). Nausea and vomiting after anesthesia did not occur in any of the patients. After removal of the endotracheal tube, laryngospasm complication occurrence in the TS group (10 cases) was higher than the other groups and no statistically significant difference was observed (P = 0.1).Conclusions:Propofol–lidocaine anesthesia regimen was more effective to control the pediatric emergence agitation than the other combinations.

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“…at the end of anaesthesia, remifentanil has been shown to decrease the incidence but it led to more postoperative nausea and vomiting [26]. In most studies that have compared propofol infusions with sevoflurane, opioids have been added to the propofol arm, thus making interpretation difficult.…”

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confidence: 99%

Emergence delirium in children

Wong

Bailey

2015

Anaesthesia

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Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children

Abstract: Small doses of propofol or fentanyl at the end of sevoflurane anaesthesia comparably reduced EA. Propofol was better than fentanyl due to a lower incidence of nausea and vomiting.

Cited by 96 publications

References 29 publications

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Efficacy and Acceptability of Different Auxiliary Drugs in Pediatric Sevoflurane Anesthesia: A Network Meta-analysis of Mixed Treatment Comparisons

Appropriate Anesthesia Regimen to Control Sevoflurane-Induced Emergence Agitation in Children: Propofol–Lidocaine and Thiopental Sodium–Lidocaine: A Randomized Controlled Trial

Emergence delirium in children

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