Haile Samrawit, Girma Timsel, Akalu Leulayehu
Department of Anesthesia, Saint Paulos Medical College, Addis Ababa, Ethiopia.
Department of Anesthesiology, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
Ann Med Surg (Lond). 2021 Aug 24;69:102765. doi: 10.1016/j.amsu.2021.102765. eCollection 2021 Sep.
Emergence agitation is a common problem that can occur after administration of general anesthesia and during recovery time especially in pediatric patients, which can result in life-threatening events if not managed adequately and timely. Usage of modern inhalational anesthetic agents like sevoflurane, isoflurane, and also halothane is a common cause for emergence agitation. Currently, the use of propofol is gaining acceptance largely on decreasing emergence agitation in addition to prevention of postoperative nausea and vomiting. The objective of this study was to assess the effectiveness of prophylaxis administration of propofol on incidence & severity of emergence agitation on pediatric patients undergo ENT & ophthalmic surgery under general anesthesia.
An institutional-based prospective cohort study was conducted on 90 patients. Patients who take 1 mg/kg of propofol were grouped into exposed while if propofol were not given grouped to non-exposed. Data were collected through intraoperative observation & by using WATCH & PAED score the patients were observed at 5, 15 & 30 min in the recovery room. Incidence of emergence agitation was analyzed by chi-square test & Mann Whitney test was applied for the severity of emergence agitation. A P-value less than 0.05 was declared as statistically significant.
From a total of 90 study participants 64% of the non-exposed group & 31% of the exposed group were developed emergence agitation which was statistically significant with p = 0.002. The severity of agitation was also higher in the non-exposed group than the exposed group at 5, 15 & 30 min with p = 0.009, 0.013, and 0.011 respectively.
Administering 1 mg/kg propofol before the end of surgery in pediatrics ENT & ophthalmic procedure under general anesthesia is effective in reducing incidence & severity of emergence agitation. Based on our findings we recommend using 1 mg/kg propofol at the end of surgery to reduce the occurrence of emergency agitation.
苏醒期躁动是全麻及苏醒过程中常见的问题，尤其在儿科患者中，若未得到充分及时的处理，可能导致危及生命的事件。使用七氟烷、异氟烷等现代吸入麻醉剂以及氟烷是引起苏醒期躁动的常见原因。目前，丙泊酚的使用在很大程度上得到认可，因为它除了能预防术后恶心呕吐外，还能减少苏醒期躁动。本研究的目的是评估预防性给予丙泊酚对接受全麻下耳鼻喉科及眼科手术的儿科患者苏醒期躁动的发生率和严重程度的有效性。
对90例患者进行了一项基于机构的前瞻性队列研究。接受1mg/kg丙泊酚的患者被归为暴露组，未给予丙泊酚的患者归为非暴露组。通过术中观察收集数据，并使用WATCH和PAED评分在恢复室对患者在5分钟、15分钟和30分钟时进行观察。苏醒期躁动的发生率通过卡方检验进行分析，Mann Whitney检验用于分析苏醒期躁动的严重程度。P值小于0.05被认为具有统计学意义。
在总共90名研究参与者中，64%的非暴露组和31%的暴露组出现了苏醒期躁动，差异具有统计学意义（p = 0.002）。在5分钟、15分钟和30分钟时，非暴露组躁动的严重程度也高于暴露组，p值分别为0.009、0.013和0.011。
在全麻下儿科耳鼻喉科及眼科手术结束前给予1mg/kg丙泊酚可有效降低苏醒期躁动的发生率和严重程度。基于我们的研究结果，我们建议在手术结束时使用1mg/kg丙泊酚以减少紧急躁动的发生。
