Comparison of propofol and fentanyl for the prevention of emergence agitation in children after sevoflurane anesthesia

Abstract

Propofol and fentanyl can be administered at the end of anesthesia to prevent emergence agitation (EA), although the superior efficacy between these agents has not been determined. This study was conducted to compare the preventive effects of EA between propofol and fentanyl administered at the end of sevoflurane anesthesia under the identical clinical conditions.Two hundred twenty-two children, 18–72 months of age, performed inguinal hernia repair under sevoflurane anesthesia received intravenous propofol 1 mg/kg (group P), fentanyl 1 ㎍/kg (group F) or saline (group S) at the end of anesthesia according to the random allocation. The incidence and severity of EA was evaluated with pediatric anesthesia emergence delirium (PAED) scale and Aono’s scale. Time to recovery and incidence of nausea/vomiting were assessed. The mean PAED score was 4.3 in group P and 4.9 in group F (P = 0.682 between two groups), which were lower than 9.0 in group S (P < 0.001). The proportion of patients with Aono’s scale ≥ 3 in group P (4.3%) and group F (12.1%) were comparable (adjusted P = 0.297) and lower than that of group S (38.6%) (adjusted P < 0.001). Nausea and vomiting was significantly more frequent in group F than in group P or group S (adjusted P = 0.003 and adjusted P < 0.001).Small dose of propofol and fentanyl at the end of anesthesia comparably reduced EA. Propofol was better than fentanyl regarding low incidence of vomiting.