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Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children

 M.-S. Kim  ;  B.-E. Moon  ;  H. Kim  ;  J.-R. Lee 
 BRITISH JOURNAL OF ANAESTHESIA, Vol.110(2) : 274-280, 2013 
Journal Title
Issue Date
Akathisia, Drug-Induced/prevention & control* ; Analgesics, Opioid/therapeutic use* ; Anesthesia Recovery Period ; Anesthesia, Inhalation* ; Anesthetics, Inhalation* ; Child ; Child, Preschool ; Double-Blind Method ; Female ; Fentanyl/therapeutic use* ; Herniorrhaphy ; Humans ; Hypnotics and Sedatives/therapeutic use* ; Infant ; Intensive Care Units, Pediatric ; Male ; Methyl Ethers* ; Postoperative Nausea and Vomiting/epidemiology ; Propofol/therapeutic use* ; Respiration, Artificial
anaesthetics i.v., propofol ; anaesthetics volatile, sevoflurane ; analgesics opioid, fentanyl ; recovery, postoperative
BACKGROUND: Propofol and fentanyl can be administered at the end of sevoflurane anaesthesia to decrease the incidence and severity of emergence agitation (EA), although it has not been determined which agent has superior efficacy. The purpose of this study was to compare the effects of propofol and fentanyl on EA. METHODS: In this prospective, randomized, double-blind study, 222 children, 18-72 months of age, undergoing sevoflurane anaesthesia were randomly assigned to one of the three groups receiving either propofol 1 mg kg(-1) (Group P), fentanyl 1 µg kg(-1) (Group F), or saline (Group S) at the end of anaesthesia. The incidence and severity of EA were evaluated with the paediatric anaesthesia emergence delirium (PAED) scale. Time to recovery and incidence of nausea/vomiting were assessed. RESULTS: The mean PAED score was 4.3 in Group P and 4.9 in Group F (P=0.682), which were lower than 9.0 in Group S (P<0.001). Nausea and vomiting were significantly more frequent in Group F than Groups P and S (adjusted P=0.003 and adjusted P<0.001). Group F had also longer stay in the post-anaesthesia care unit (PACU) than Group S (P<0.001), while Group P did not. However, the differences in PACU stays between the P and F groups were considered clinically insignificant. CONCLUSION: Small doses of propofol or fentanyl at the end of sevoflurane anaesthesia comparably reduced EA. Propofol was better than fentanyl due to a lower incidence of nausea and vomiting.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Kim, Hyun Zu(김현주B)
Moon, Bo Eun(문보은)
Lee, Jeong Rim(이정림) ORCID logo https://orcid.org/0000-0002-7425-0462
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