Comparing incidence of emergence delirium between sevoflurane and desflurane in children following routine otolaryngology procedures

BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated Pediatric Emergence Delirium (PAED) Scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat surgery.

METHODS: Forty-six children aged 12 months-7 years were randomly assigned to receive either sevoflurane (N.=23) or desflurane (N.=23) for maintenance of general anesthesia. All patients were extubated awake in the OR, and upon arrival in the PACU, PAED scores were assessed every 15 minutes until discharged. In addition to PAED scores, time to tracheal extubation, emergence behavior, pain scores, and recovery complications were recorded.

RESULTS: We found no significant difference in incidence of ED or peak PAED scores between sevoflurane and desflurane groups (12 [0-18] versus 12 [0-20]; P=0.79). There were no significant differences between desflurane and sevoflurane with respect to incidence of adverse events, such as nausea, vomiting, laryngospasm, or excessive secretions.

CONCLUSIONS: In conclusion, the use of desflurane for maintenance of anesthesia did not significantly affect the incidence or duration of ED when compared to sevoflurane. However, desflurane did not demonstrate any increase in adverse events, which may support its routine use in this patient population.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:83

Enthalten in:

Minerva anestesiologica - 83(2017), 4 vom: 10. Apr., Seite 383-391

Sprache:

Englisch

Beteiligte Personen:

Driscoll, Jeremy N [VerfasserIn]
Bender, Brian M [VerfasserIn]
Archilla, Carlos A [VerfasserIn]
Klim, Carol M [VerfasserIn]
Hossain, Md J [VerfasserIn]
Mychaskiw, George [VerfasserIn]
Wei, Julie L [VerfasserIn]

Links:

Volltext

Themen:

38LVP0K73A
Anesthetics, Inhalation
CRS35BZ94Q
Comparative Study
Desflurane
Journal Article
Randomized Controlled Trial
Sevoflurane

Anmerkungen:

Date Completed 08.07.2019

Date Revised 08.07.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.23736/S0375-9393.16.11362-8

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM26668081X