Greater Incidence of Emergence Agitation in Children after Sevoflurane Anesthesia as Compared with Halothane

Abstract

This meta-analysis revealed that emergence agitation occurred more frequently with sevoflurane than with halothane anesthesia in children.

The change of sevoflurane to desflurane after anesthesia induction induces rapid emergence without increased cardiovascular responses and emergence delirium in pediatric strabismus surgery patients

“…Most emergence delirium disappeared within 1 hour, but it can be dangerous, as patients may fall out of the bed, pull out an IV line, and it makes parents anxious. It also results in a prolonged PACU stay [8][9][10]. Although emergence delirium has recently been investigated by several studies, the exact etiology remains unclear.…”

“…Although emergence delirium has recently been investigated by several studies, the exact etiology remains unclear. It has been known to be related with pain, a side effect of the medicine, age, preoperative anxiety, and rapid emergence due to the low solubility of inhaled agents [8][9][10]. Volatile anesthetics such as sevoflurane and desflurane have been known to aggravate emergence delirium because of their rapid recovery.…”

“…Predisposing factors of emergence agitation are not fully known, but rapid emergence may lead to emergence agitation [8][9][10]. These adverse effects can cause sympathetic hyperactivity, prolonged hospital stay, and decreased patient satisfaction.…”

Methods and madness: agitation, delirium, and postoperative cognitive dysfunction

“…Two recent systematic reviews 11,12 identifying over fifty randomized controlled trials and over 5,300 patients highlight the variability in both assessment tools and definition of outcome. Kuratani and Oi identify a significant limitation to the findings, i.e., ''…most studies used a self-made non validated rating scale to evaluate emergence agitation, which focused more on behavioural than on psychometric factors''.…”

“…Kuratani and Oi identify a significant limitation to the findings, i.e., ''…most studies used a self-made non validated rating scale to evaluate emergence agitation, which focused more on behavioural than on psychometric factors''. 11 The authors of both studies call for the use of the Pediatric Anesthesia Emergence Delirium (PAED) 13 scale in future research. The PAED scale, developed in 2004 by researchers from the Hospital for Sick Children, Toronto, evaluates five behaviours (eye contact, purposeful action, awareness of surroundings, restlessness, and consolability) that are scored from 1 to 4.…”