Mechanism of emergence agitation induced by sevoflurane anesthesia

Kim, Jaehwan

doi:10.4097/kjae.2011.60.2.73

Cited by 20 publications

(21 citation statements)

References 9 publications

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“…21 It has been suggested that rapid elimination of sevoflurane due to its low solubility in the blood can cause EA. 24 Incidence rates of 55.4% and 54.3% for EA among nasal surgery patients have been reported in the literature. 8,15 In our study, all patients received sevoflurane for general anesthesia and underwent septorhinoplasty which caused high postoperative pain and shortness of breath in the early postoperative period.…”

Section: Discussionmentioning

confidence: 98%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty. Patients and Methods: Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded. Results: The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001). Conclusion: Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.

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Section: Discussionmentioning

confidence: 98%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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“…In addition, genetic factors may also be relevant. Genetic differences in pain sensitivity [18], responses to analgesics due to alterations of pharmacokinetic and pharmacodynamic parameters [19,20], and emergence agitation [21] have been reported. Additionally, there may be differences associated with race.…”

Section: Discussionmentioning

confidence: 99%

Magnesium Supplementation and Postoperative Recovery Quality in Children Undergoing Strabismus Surgery: A Prospective, Randomised, Controlled Study

J¹,

Choi²,

M³

et al. 2020

Preprint

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Background: The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anesthesia on emergence agitation and postoperative pain in children were evaluated.Methods: A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Preoperative anxiety was assessed using the modified Yale Preoperative Anxiety Scale. After anesthesia induction, the magnesium group received an initial loading dose of 30 mg/kg magnesium sulphate over 10 min and, then, continuous infusion of 10 mg/kg per h until 10 min before the end of the surgery. The control group received an equal volume of normal saline via the same regimen. The Pediatric Anesthesia Emergence Delirium (PAED) score, pain score, and respiratory events were assessed at the postanesthetic care unit.Results: Data obtained from 65 children were analyzed. The PAED and pain scores of the two groups did not differ significantly. There were 26 of 33 (78.8%) and 27 of 32 (84.4%) children with emergence agitation in the control and the magnesium groups, respectively (odds ratio 0.69, 95% CI 0.19–2.44; p = 0.561). The preoperative anxiety score was not significantly correlated with the PAED score. The incidence of respiratory events during the emergence period did not differ significantly between the two groups. Conclusions: Magnesium supplementation during anesthesia had no significant effects on the incidence of emergence agitation or postoperative pain in children undergoing strabismus surgery.Clinical trial registry: ClinicalTrials.gov (NCT03132701)

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“…EA in children is a multifactorial disease [1,8]. Objective measurement of agitation is difficult since there is no strict definition, and multiple different scales are currently in use [14].…”

Section: Discussionmentioning

confidence: 99%

“…Sevoflurane is the most used volatile agent despite its potency in producing EA [1,2,7]. This is due to its pharmacological content that binds in GABA A receptors in α and γ subsegments [8].…”

Section: Introductionmentioning

confidence: 99%

Low-Flow Anesthesia Technique Reduces Emergence Agitation in Pediatric Patients Underwent General Anesthesia

Ryalino

Senapathi

Pradhana

et al. 2019

Asian J Pharm Clin Res

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Objectives: This study was designed to see the risk factors that contribute to emergence agitation (EA) and also to know the effectiveness of low-flow (LF) anesthesia technique in EA in pediatric patients. Methods: A total of 200 pediatric patients aged 6 months–6 years underwent surgery with general anesthesia were divided into two groups. The high-flow (HF) group was maintained with 5 l fresh gas flow (FGF), and the LF group was maintained with 500 ml FGF. The outcome was measured after the surgery was completed on Face, Legs, Activity, Cry, and Consolability and pediatric anesthesia emergence delirium (PAED) scores. Agitation defined in PAED score ≥10, and no agitation defined in PAED score <10. Results: EA incidence in the HF group was higher compared to the LF group (59.5 vs. 4.7%, p<0.001). HF anesthesia technique was a single risk factor for agitation event, whereas LF anesthesia may prevent EA incidence until up to 92.7%. Conclusion: LF anesthesia reduced agitation incidences. The effectiveness of LF was 92.7% in reducing the incidence of agitation. HF anesthesia was the main risk factor for agitation incidences.

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Mechanism of emergence agitation induced by sevoflurane anesthesia

Cited by 20 publications

References 9 publications

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Magnesium Supplementation and Postoperative Recovery Quality in Children Undergoing Strabismus Surgery: A Prospective, Randomised, Controlled Study

Low-Flow Anesthesia Technique Reduces Emergence Agitation in Pediatric Patients Underwent General Anesthesia

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