Fentanyl and Propofol Used at The Conclusion of Anesthesia in Pediatrics Patients to Reduce Emerging Anxiety Following Sevoflurane Anesthesia

A Comparative Study in Libyan Patients

المؤلفون

  • Ibrahim Garta جامعة مصراتة -كلية الطب البشري
  • Omar Alhaddad Department of Family and Community Medicine, Faculty of Medicine Misurata University Libya
  • Abdulrahman eldanfour Anesthesia Department Misurata central hospital Libya
  • FATHI ABULIFA Department of Surgery, Faculty of medicine, Misurata University, Libya
  • Ahmed Aniba Department of Surgery, Faculty of medicine, Misurata University Libya

الكلمات المفتاحية:

Anaesthetics، propofol، sevoflurane، fentanyl، Misurata

الملخص

Background: The optimal drug for reducing emergence agitation (EA) after sevoflurane anesthesia remains unclear, with both propofol and fentanyl as potential options.

Aim: This study aimed to compare the effects of fentanyl and propofol on the incidence and severity of postoperative agitation and excitement following sevoflurane anesthesia.

Methods: Sixty-six children who underwent sevoflurane anesthesia were prospectively assigned to three groups. Group P received propofol 1 mg/kg, Group F received fentanyl 1 μg/kg, and Group S received saline. EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale, alongside recovery time and the occurrence of nausea and vomiting.

Results: Group P and Group F had mean PAED scores of 5.05 and 5.2, respectively (p=0.715), significantly lower than Group S (14, p<0.001). Group F had a significantly higher frequency of nausea and vomiting compared to Group P (p<0.001), while differences between Groups P and S were not clinically significant. Group P had a shorter stay in the post-anesthesia care unit (PACU) than Group F (p=0.06), though this difference was not clinically significant. However, Group F had a significantly longer PACU stay than Group S (p=0.01).

Conclusion: Both propofol and fentanyl reduced the incidence of EA after sevoflurane anesthesia, but propofol was associated with a lower rate of nausea and vomiting, making it the preferable option.

المراجع

Abu-Shahwan, "The impact of propofol on children's emerging behaviour following sevoflurane general anaesthesia," Paediatr Anaesth, vol. 18, pp. 55-59, 2008.

J. H. Bleik, M. F. El-Khatib, M. T. Aouad, V. G. Yazbeck-Karam, V. G. Nasr, G. E. Kanazi, et al., "Propofol is given once during surgery to children receiving strabismus surgery under sevoflurane anaesthesia in order to prevent emerging anxiety," Anaesthesiology, vol. 107, pp. 733-738, 2007.

Y. Oi and N. Kuratani, "An increased frequency of emergent agitation in children following sevoflurane anaesthesia in contrast to halothane: a meta-analysis of randomised controlled studies," Anaesthesiology, vol. 109, pp. 225-232, 2008.

R. M. Cuy, L. M. Fazi, J. L. Galinkin, et al., "Using intranasal fentanyl when halothane and sevoflurane anaesthesia are being administered to youngsters having a myringotomy and fitting tubes," Anaesthesia, vol. 93, p. 1378, 2000.

H. Ture, O. Koner, F. Menda, S. Sozubir, A. Mercan, "Premedication with hydroxyzine and midazolam and its effects on sevoflurane-induced paediatric emergence agitation: a prospective randomised clinical trial," Eu J Anaesth, vol. 28, pp. 640-645, 2011.

T. Goto, K. Terui, S. Uezono, et al., "Sevoflurane versus propofol for paediatric patients: early agitation following the latter," Anesth Analg, vol. 91, pp. 563-566, 2000.

Y. J. Chang, H. J. Kwak, H. Y. Park, J. Y. Lee, J. Y. Kim, "For children undergoing an adenotonsillectomy, post-induction albendazole lowers sevoflurane-associated emerging agitation," Actua Anaesthesiol Scand, vol. 53, pp. 678-681, 2009.

C. Brasher, I. Stany, S. Dahmani, et al., "Medicinal management of emerging agitation caused by desflurane and sevoflurane in children: a review of the literature," Br J Anaesth, vol. 104, no. 2, pp. 216-223, 2010.

K. Chowdary and I. Abu-Shahwan, "When children are receiving dental repair under sevoflurane general anaesthesia, ketamine can reduce the likelihood of emerging agitation," Paediatr Anaesth, vol. 17, pp. 846-850, 2007.

M. Beach, B. Thyr, K. Whalen, and J. P. Cravero, "The impact of low dosage fentanyl on paediatric patients' features upon awakening from sevoflurane anaesthesia in the absence of surgery," Anesth Analg, vol. 97, pp. 364-367, 2003.

C. M. Liou, W. Y. Tsai, W. T. Hung, and C. C. Chen, "Low-dose fentanyl's impact on persons with moderate developmental impairments' quality of life and emerging agitation," J Clin Anesth, vol. 17, pp. 494-498, 2005.

J. Lerman and N. Sikich, "The development and psychometric assessment of the paediatric emerging delirium scale during anaesthesia," Anaesthesiology, vol. 100, pp. 1138-1145, 2004.

K. Whalen, S. Surgenor, and J. Cravero, "A comparison with halothane of emergent agitation in paediatric patients under sevoflurane anaesthesia without surgery," Paediatr Anaesth, vol. 10, pp. 419-424, 2000.

D. Costi, A. M. Cyna, and S. A. Bajwa, "A comparison between children's post-general anaesthesia emerging delirium scores," Paediatr Anaesth, vol. 20, pp. 704-711, 2010.

D. Wang, X. Hu, W. Li, and J. Chen, "A comparison between midazolam, propofol, and ketamine for the treatment of emergent agitation in children following cataract surgery," Paediatr Anaesth, vol. 20, pp. 873-879, 2010.

J. C. Finkel, K. M. Patel, K. A. Hummer, R. S. Hannallah, and I. T. Cohen, "Fentanyl's effect on children's emerging traits following desflurane or sevoflurane anaesthesia," Anesth Analg, vol. 94, pp. 1178-1181, 2002.

S. M. Yoon, Y. H. Kim, H. J. Lim, and S. Z. Yoon, "Preventive use of propofol or midazolam at the conclusion of surgery may lessen the likelihood of emerging agitation following sevoflurane anaesthesia," Paediatr Anaesth, vol. 39, pp. 904-908, 2011.

N. S. Morton and D. A. Varveris, "An open pilot research using target controlled infusion of propofol for the induction and maintenance of anaesthesia using the paedfusor," Paediatr Anaesth, vol. 12, pp. 589-593, 2002.

C. Prys-Roberts, R. M. Tackley, G. T. Lewis, J. Dixon, and F. L. Roberts, "The induction and maintenance of anaesthesia using propofol: a plan for manual injection," Anaesthesia, vol. 43, Suppl., pp. 14-17, 1988.

S. Drewsen, R. S. Hannallah, and I. T. Cohen, "In children having adenotonsillectomy, propofol or midazolam do not lessen the prevalence of emerging agitation linked to desflurane anaesthesia," Paediatr Anaesth, vol. 12, pp. 589-593, 2002.

T. Craddock, Bell M, and BC Weldon. Comparing the impact of caudal analgesia and halothane anaesthesia on children's emerging agitation post-anesthesia. In 2004; 98: 321–326, Anesth Analg

التنزيلات

منشور

2024-07-07

كيفية الاقتباس

Garta, I., Alhaddad, O., eldanfour, A., ABULIFA, F., & Aniba, A. (2024). Fentanyl and Propofol Used at The Conclusion of Anesthesia in Pediatrics Patients to Reduce Emerging Anxiety Following Sevoflurane Anesthesia: A Comparative Study in Libyan Patients. مجلة البحوث الأكاديمية, 28(2), 66–75. استرجع في من https://lam-journal.ly/index.php/jar/article/view/717

إصدار

القسم

العلوم الأساسية