Emergence Delirium, Anesthesia
Conditions
Keywords
Emergence agitation in anesthesia
Brief summary
This study aim to compare the effect of intravenous propofol versus intravenous lidocaine on emergence agitation in children undergoing tonsillectomy or adenotonsillectomy under general anesthesia.
Detailed description
Tonsillectomy is one of the common surgeries in children, which is associated with many morbidities such as postoperative pain, nausea, vomiting, bleeding, dehydration and emergence agitation . Emergence agitation (EA) is a prevalent occurance following sevoflorane anesthesia , with an incidence of up to 80% , particularly among preschool children EA is characterised by a dissociated state of consciousness' in which the child displays irritability, anxiety , and inconsolable crying, kicking, or thrashing behavior Furthermore , EA in children can potentially be dangerous as it may lead to incidents such as falling out of bed , removal of surgical dressings , intravenous catheters , increase stress for healthcare providera and parents , higher costs due to prolonged recovery stay .³ The mechanism of EA remains unclear. The proposed risk factors of EA include age ,preoperative anxiety,, type of surgery, emergency operation, use of inhalational anesthetics , long duration of surgery. Several pharmacological prophylactic interventions ,including opioids analgesics , benzodiazepines, α2-adrenergic receptor agonists such as clonidine , have been studied for their potential to reduce incedence of EA . Propofol, short acting intravenous anesthetic, is known for smoother emergence and sedative properties. Lidocaine, administered intravenously, has analgesic, anti-inflammatory, and sedative effects. There is limited direct comparison between these two drugs specifically in pediatrc tonsillectomy with EA. So, does intravenous lidocaine compared with propofol reduce the incidence and severity of emergence agitation in children undergoing tonsillectomy or adenotonsillectomy ?
Interventions
DRUGPropofol
In pediatric tonsillectomy after the end of surgery, patient will recieve 1 mg/kg of propofol iv bolus
In pediatric tonsillectomy after the end of the surgery , patient will recieve 1.5 mg/kg of lidocaine iv bolus
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
4 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
* Elective tonsillectomy operation * pediaterics between ( 4 : 7 ) years old * ASA I OR II
Exclusion criteria
* emergency cases as bleeding tonsills * ASA III OR IV
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare the incidence and severity of emergence agitation (EA) between children receiving propofol and those receiving lidocaine using Pediatric Anesthesia Emergence Delirium (PAED) scale. | Within 30 minutes after extubation | Pediatric Anesthesia Emergence Delirium (PAED) scale (range 0-20; higher scores indicate more severe agitation). |
| To compare the incidence and severity of emergence agitation (EA) between children receiving propofol and those receiving lidocaine using WATCHA scale | Within 30 minutes after extubation. | Watcha agitation scale (range 0-4; higher scores indicate more severe agitation). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| extubation time | Within 30 minutes after extubation. | — |
| post-operative pain using FLACC score | Within 30 minutes after extubation. | The FLACC scale is used to assess postoperative pain in children. It consists of 5 categories (Face, Legs, Activity, Cry, Consolability), each scored 0-2, giving a total score range of 0-10. |
| emergence time from anesthesia | Within 30 minutes after extubation. | — |
| Post operative nausea and vomitting | Within 30 minutes after extubation. | — |
| Hemodynamic effects as hypotention and bradycardia | Within 30 minutes after extubation. | — |
| peaked PAED scores | Within 30 minutes after extubation. | Pediatric Anesthesia Emergence Delirium (PAED) scale (range 0-20; higher scores indicate more severe agitation). |
Countries
Egypt
Contacts
Primary ContactHesham Bahaaeldin Mohamed, Resident doctor
Outcome results
None listed