Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children – a randomized controlled study

Meyer, Roland Richard; Münster, Peter; Werner, Christian; Brambrink, Ansgar M.

doi:10.1111/j.1460-9592.2006.01998.x

Cited by 51 publications

(33 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Modern concepts for postoperative analgesia, have changed the atmosphere in the recovery rooms; and today postoperative agitation is considered as an abnormal and frightening behavior (66). However, even in pain‐free patients, postoperative agitation is common in preschool children after sevoflurane (30), desflurane (67), and isoflurane (68,69) based anesthetics. Pediatric anesthesiologists should all be familiar with strategies for the prevention and treatment of agitation; the most evident option would be, however, to avoid inhalational agents for maintenance at all, and to use propofol instead (33,70).…”

Section: Total Intravenous Anesthesia In Pediatrics (By Martin Jöhr)mentioning

confidence: 99%

Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia

Lerman

Jöhr

2009

Pediatric Anesthesia

View full text Add to dashboard Cite

Section: Total Intravenous Anesthesia In Pediatrics (By Martin Jöhr)mentioning

confidence: 99%

Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia

Lerman

Jöhr

2009

Pediatric Anesthesia

View full text Add to dashboard Cite

“…The first theory is that emergence agitation occurs due to the changes and relationship of gamma-aminobutyric acid A receptors in the central nervous system, and in the model of Sachedev and Kruck, the mechanism of excitement is explained as resulting from decreased inhibitory signals from the globus pallidus interna and substantia nigra, and the inability to suppress thalamocortical neurons and brain stem neurons due to disorder in the nervous system (Lindenmayer, 2000). Another explanation proposed by Meyer et al (2007) is that the cause of emergence agitation results from the difference in recovery speed within the nervous system, increasing the sensitivity to stimulation from the surrounding environment and creating a state of functional dissociation.…”

Section: Discussionmentioning

confidence: 99%

“…high incidence of emergence agitation in pediatric patients (Meyer et al, 2007). Compared to inhalation anesthetics, propofol has a decreased occurrence of nausea and vomiting, and characteristically has a lower occurrence of hangover.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of emergence agitation between isoflurane and propofol anesthesia in adults after closed reduction of distal radius fracture

2014

View full text Add to dashboard Cite

ABSTRACT. Distal radius fracture is a common wound. It is reduced by surgery under anesthesia. Emergence agitation can often occur after anesthesia. It is associated with increased morbidity and hospital costs. However, there have been almost no reports in the medical literature on the occurrence of emergence agitation in adults. This study aimed to compare emergence agitation between isoflurane and propofol anesthesia in adults after closed reduction of distal radius fracture. Forty adults (ASA I-II) undergoing closed reduction of distal radius fracture were randomly assigned to either the isoflurane or propofol group and anesthesia was maintained with isoflurane or propofol. The bispectral index was monitored and maintained within 40-60. After reduction of fracture and fixation with plaster, patients were transported to the post-anesthetic care unit (PACU) and agitation state scale was checked by Aono's four-point scale (AFPS). AFPS score of 3 or 4 was considered to be emergence agitation. Pain scores were measured by the numeric rating scale (NRS) on arrival and at peak value at PACU. Eight (40.0%) patients in the isoflurane group and 2 (10.0%) patients in the propofol group developed emergence agitation (P = 0.031). There was no correlation between peak NRS and AFPS. Propofol may decrease the incidence of emergence agitation compared to isoflurane in adults undergoing closed reduction of distal radius fracture.

show abstract

“…However, a new phenomenon began to emerge and that was the presence of emergence delirium [41,42,43,44,45]. Our panacea for a smoother induction, shorter anesthetic course was now troubled with a postoperative concern.…”

Section: Historymentioning

confidence: 99%

Anesthesia and the Developing Brain: Relevance to the Pediatric Cardiac Surgery

2014

View full text Add to dashboard Cite

Anesthetic neurotoxicity has been a hot topic in anesthesia for the past decade. It is of special interest to pediatric anesthesiologists. A subgroup of children potentially at greater risk for anesthetic neurotoxicity, based on a prolonged anesthetic exposure early in development, are those children receiving anesthesia for surgical repair of congenital heart disease. These children have a known risk of neurologic deficit after cardiopulmonary bypass for surgical repair of congenital heart disease. Yet, the type of anesthesia used has not been considered as a potential etiology for their neurologic deficits. These children not only receive prolonged anesthetic exposure during surgical repair, but also receive repeated anesthetic exposures during a critical period of brain development. Their propensity to abnormal brain development, as a result of congenital heart disease, may modify their risk of anesthetic neurotoxicity. This review article provides an overview of anesthetic neurotoxicity from the perspective of a pediatric cardiac anesthesiologist and provides insight into basic science and clinical investigations as it relates to this unique group of children who have been studied over several decades for their risk of neurologic injury.

show abstract

Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children – a randomized controlled study

Abstract: In our randomized controlled study, we found no difference in the incidence of EA or ED between sevoflurane and isoflurane. Therefore, the decision to use one or the other should not be based upon the incidence of EA or ED.

Cited by 51 publications

References 21 publications

Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia

Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia

Comparative study of emergence agitation between isoflurane and propofol anesthesia in adults after closed reduction of distal radius fracture

Anesthesia and the Developing Brain: Relevance to the Pediatric Cardiac Surgery

Contact Info

Product

Resources

About