Recovery Characteristics of Sevoflurane and Halothane in Preschool-Aged Children Undergoing Bilateral Myringotomy and Pressure Equalization Tube Insertion

Similar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication

“…Psychomotor excitation after sevoflurane anaesthesia in children, proposed to be associated with postoperative anxiety, remaining drug effects or pain (1, 2, 6, 10),represents a considerable clinical problem (6, 11), particularly in preschool children (5, 12), after rapid emergence procedures (13) and in noisy spostoperative environments (5, 6, 14).…”

“…Postoperative excitation after sevoflurane anaesthesia has been suggested both to be (1, 2, 6, 10) and not to be (3, 5) associated with postoperative pain. Accordingly, adequate pain relief has been found to reduce (2, 10) or have no effect on (11) agitation early after sevoflurane anaesthesia.…”

“…F or almost a decade sevoflurane has been the volatile agent of choice for maintenance of general anaesthesia in Sweden and proved most useful in modern day‐care paediatric anaesthesia (1). The smooth induction and elimination characteristics (2–4) are particularly appreciated in younger patients despite frequent agitation in the early postoperative period, particularly in preschool children (5–7), recently found to be attenuated by analgesics (6).…”

Assessment of risk factors for emergence distress and postoperative behavioural changes in children following general anaesthesia

“…Hypoxaemia and metabolic disturbances may cause mental status changes, including agitation. The presence of postoperative pain has been implicated as a cause of emergence distress in many investigations (5–8). In one study, Davis et al .…”

“…In one study, Davis et al . (6) noted that in preschool children, emergence distress and pain behaviour may be indistinguishable from each other. Multiple investigators have also found that emergence distress is more likely to occur in younger vs older children (1,5,9).…”