Ramlan Andi Ade Wijaya, Pardede Dimas K Bonardo, Marsaban Arif H M S, Hidayat Jefferson, Peddyandhari Fildza Sasri
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
J Anaesthesiol Clin Pharmacol. 2020 Apr-Jun;36(2):177-181. doi: 10.4103/joacp.JOACP_257_19. Epub 2020 Jun 15.
Emergence agitation (EA) is a common transient behavioral disturbance after inhalational anesthesia and may cause harm to the patient. This study evaluated the efficacy of 0.5 mg/kg of propofol administered at the end of anesthesia to reduce the incidence of EA in children undergoing general inhalational anesthesia.
This double-blind randomized clinical trial was done in children aged 1-5 years undergoing general anesthesia with sevoflurane. One hundred and eight subjects were included using consecutive sampling method and randomized into two equal groups. Propofol in the dose of 0.5 mg/kg was administered at the end of anesthesia to children in the propofol group, while those in the control group did not receive any intervention at the end of anesthesia. Incidence of EA, transfer time, postoperative hypotension, desaturation, and nausea-vomiting were observed. Aono and scale were used to assess EA.
Incidence of EA was 25.9% in the propofol group compared to 51.9% in the control group (RR = 0.500; 95% CI 0.298-0.840; = 0.006). Mean transfer time in propofol group was longer (9.5 ± 3.9 min) than control group (7.8 ± 3.6 min) (mean difference 1.71 min; 95% CI 0.28-3.14; = 0.020). Hypotension was found in one patient (1.9%) in propofol group, while in control group there was none. Nausea-vomiting was found in five patients (9.3%) in propofol group and eight patients (14.8%) in control. There was no desaturation in both the groups.
Administration of 0.5 mg/kg of propofol at the end of anesthesia effectively reduces the incidence of EA in children undergoing general inhalational anesthesia with sevoflurane.
苏醒期躁动(EA)是吸入麻醉后常见的短暂性行为紊乱,可能对患者造成伤害。本研究评估在麻醉结束时给予0.5mg/kg丙泊酚对降低接受全身吸入麻醉儿童EA发生率的效果。
本双盲随机临床试验在1至5岁接受七氟醚全身麻醉的儿童中进行。采用连续抽样法纳入108名受试者,并随机分为两组,每组人数相等。丙泊酚组儿童在麻醉结束时给予0.5mg/kg丙泊酚,而对照组在麻醉结束时不接受任何干预。观察EA发生率、转运时间、术后低血压、血氧饱和度下降及恶心呕吐情况。采用青木评分评估EA。
丙泊酚组EA发生率为25.9%,对照组为51.9%(RR = 0.500;95%CI 0.298 - 0.840;P = 0.006)。丙泊酚组平均转运时间(9.5±3.9分钟)长于对照组(7.8±3.6分钟)(平均差值1.71分钟;95%CI 0.28 - 3.14;P = 0.020)。丙泊酚组有1名患者(1.9%)出现低血压,而对照组无。丙泊酚组有5名患者(9.3%)出现恶心呕吐,对照组有8名患者(14.8%)出现恶心呕吐。两组均未出现血氧饱和度下降。
在麻醉结束时给予0.5mg/kg丙泊酚可有效降低接受七氟醚全身吸入麻醉儿童的EA发生率。