Emergence Delirium, Intravenous Anesthesia, Sevoflurane
Conditions
Brief summary
Emergence agitation (EA), a phenomenon observed at the time of recovery from general anesthesia (GA).The cause of ED appears to be multifactorial in origin. Use of volatile anesthetics, prolonged duration and type of surgery, pain, and rapid emergence are some factors known to increase its incidence
Detailed description
The pathogenesis of postoperative EA is still undefined, but sevoflurane has intrinsic effects that may share in emergence agitation like its different electroencephalogram pattern from halothane, and its degradation to inorganic fluoride ions and compound A which may have a role in the occurrence of EA Sevoflurane now is the inhalational anaesthetic agent of choice for pediatrics, as it is non-pungent, with minimal airway irritation characters, and its cardiac adverse effects are minimal like cardiac depression and dysrhythmias. Total intravenous anesthesia (TIVA) using propofol and fentanyl appears to have a smooth recovery profile
Interventions
DRUGsevoflurane
sevoflurane (1-1.2 MAC)
DRUGpropofol
100-400 mcg/kg /min of propofol
Sponsors
Benha University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
In group Sevoflurane, anesthesia was maintained with sevoflurane (1-1.2 MAC) with oxygen /air 1:1. In group propofol , anesthesia was maintained continuous infusion of 100-400 mcg/kg /min of propofol and fentanyl 0.1 ug / kg/ min with oxygen /air 1:1.
Eligibility
Sex/Gender
ALL
Age
1 Years to 8 Years
Healthy volunteers
No
Inclusion criteria
* ages 1 to 8 years * American society of anesthesiologists (ASA) physical status I and II, scheduled for hypospadias repair
Exclusion criteria
* children with a history of active airway disease, * sleep apnoea, developmental delay, * psychological, * neurological disorder, * cardiovascular abnormality or requirement of post-operative ventilation, * hepatic impairment, and renal insufficiency, with active upper respiratory tract infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emergence delirium | 24 hours | The pediatric anesthesia emergence delirium (PAED) scale. Each must be evaluated as not at all, just a little, quite a bit, very much, or extremely, where the first three items to be scored reversely (4 = not at all, 0 = extremely) while the last two items to be scored regularly. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| FLACC | Postoperatively at 24 hours | The Face, Legs, Activity, Cry, and Consolability scale is a frequently used tool for pain assessment in children, with a total score of 0 to 10 |
Countries
Egypt
Contacts
Primary ContactRamy Saleh, MD
Outcome results
None listed