Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 4 Issue 8

Comparison of Propofol and Fentanyl in Prevention of Emergence of Delirium after Sevoflurane Anesthesia

Hiren R Patel1* and Geeta Parikh2

1Kasturba Vaidyakiya Rahat Mandal, Gujarat, India
2Department of Anaesthesiology and Critical Care, Institute of Kidney Disease and Research Center, and Institute of Transplant Sciences, Civil Hospital Campus, Ahmedabad, India

*Corresponding Author: Hiren R Patel, Kasturba Vaidyakiya Rahat Mandal, Gujarat, India.

Received: July 09, 2020; Published: July 20, 2020

×

Abstract

Introduction: The occurrence of emergence agitation in children after sevoflurane anaesthesia is common with an incidence ranging between 10 to 80%.

Aim: To study Propofol and Fentanyl in Prevention of Emergence of Delirium after Sevoflurane Anesthesia.

Material and Methods: After approval from ethical committee and written informed consent from parents or guardian, 115 children with ASAI and II aged 2 to 6 years, were selected for elective urological surgery, under sevoflurane anaesthesia. Patients were divided into three groups i.e. Group C (Control), Group F (Fentanyl), and Group P (Propofol). All collected data enter into the IBM SPSS 20th (statistical parameter of soci 20th and analyzed it. Continuous data expressed as mean ± sd and non-continuous expressed as in percentages. Anova test, kruskal wallis and chi square (fisher exact) test have been performed to carry out p value at 95% CI. p value <0.05 shows statistically significant.

Result: In score 1, child is obtunded with no response to stimulation, in stage 2, child is asleep but responsive to movement or stimulation, in stage 3, child is awake and responsive while score 4 includes crying and in score 5 thrashing behavior that requires restraint. We found highest score in group S that is around 4 compared to group F and group P. The control group children were awake and responsive but most of the children were crying from five minutes onwards and some children had thrashing behavior. Amongst group F and group P, group P is better than group f. Group P children were more sedated compared to group F. After 30 minutes, almost all children were awake and responsive. This emergence of Agitation at 5 min, 10 min, 15 min was significantly higher in Control and Propofol group as compared to Fentanyl and Control (P < 0.01 respectively).

Conclusion: We concluded that fentanyl and propofol both have effect on reduction of emergence agitation after sevoflurane anaesthesia but the children of propofol group remains calm and quiet and have significant reduction in emergence delirium than fentanyl at 10 and 15 mins after discontinuation of sevoflurane anaesthesia.

Keywords: Propofol; Fentanyl; Sevoflurane; Emergence of Delirium

×

References

  1. Lerman J., et al. “The pharmacology sevoflurane in infants and children”. Anaesthesiology 80 (1994): 814-824.
  2. Abu-Shahwan I. “Effect of propofol on emergence behavior in children after sevoflurane general anesthesia”. Paediatric Anaesthesia 18 (2008): 55-59.
  3. Aouad MT., et al. “A single dose of propofol at the end of surgery for the prevention of emergence agitation in children undergoing strabismus surgery during sevoflurane anesthesia”. Anaesthesiology 107 (2007): 733-738.
  4. Dahmani S., et al. “Pharmacological prevention of sevoflurane and desflurane - related emergence agitation in children: A meta analysis of published studies”. British Journal of Anaesthesia 104 (2010): 216-223.
  5. Finkel JC., et al. “The effect of intra nasal fentanyl on emergence characteristic after sevoflurane anaesthesia in children undergoing surgery for bilateral myringotomy tube placement”. Anesthesia and Analgesia5 (2001): 1164-1168.
  6. Cohen IT., et al. “The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children”. Anesthesia and Analgesia 94 (2002): 1178-1181.
  7. SAMY A., et al. “Effects of Fentanyl and Dexmedetomidine Infusion on Tracheal Intubation and Emergence Agitation in Children Anesthetized with Sevoflurane”. Medical Journal of Cairo University 80 (2012): 245-252.
  8. CRAVERO J., et al. “Emergence agitation in paediatric patients after sevoflurane anaesthesia and no surgery: A comparison with halothane”. Pediatric Anesthesia 10 (2000): 419-424.
  9. Fenmei shi., et al. “Effects of Fentanyl on Emergence Agitation in Children under Sevoflurane Anesthesia: Meta-Analysis of Randomized Controlled Trials”. Plos One (2015).
  10. Cravero JP., et al. “The effect of small dose fentanyl on the emergence characteristics of pediatric patients after sevoflurane anesthesia without surgery”. Anesthesia and Analgesia 97 (2003): 364.
  11. Ashraf Arafat Abdelhalim and Ahmed Mohamed Alarfaj. “The effect of ketamine versus fentanyl on the incidence of emergence agitation after sevoflurane anaesthesia in pediatric patients undergoing tonsillectomy with or without adenoidectomy”. Saudi Journal of Anaesthesia4 (2013): 392-398.
  12. Chen J., et al. “Emergence agitation after cataract surgery in children: a comparison of midazolam, propofol and ketamine”. Paediatric Anaesthesia 20 (2010): 873-879.
  13. Kim YH., et al. “Prophylactic use of midazolam or propofol at the end of surgery may reduce the incidence of emergence agitation after sevoflurane anaesthesia”. Anaesthesia In-tensive Care 39 (2011): 904-908.
  14. Ibrahim Abu-Shahwan. “The effect of propofol on emergence agitation in children”. Paediatric Anaesthesia 1 (2008).
  15. Varveris DA and Morton NS. “Target controlled infusion of propofol for induction and maintenance of anaesthesia using the paedfusor: an open pilot study”. Paediatric Anaesthesia 12 (2002): 589-593.
  16. Roberts FL., et al. “Induction and maintenance of propofol anaesthesia. A manual infusion scheme”. Anaesthesia 43 (1988): 14-17.
  17. Kim MS., et al. “Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children”. British Journal of Anaesthesia2 (2013): 274-280.
×

Citation

Citation: Hiren R Patel and Geeta Parikh. “Comparison of Propofol and Fentanyl in Prevention of Emergence of Delirium after Sevoflurane Anesthesia". Acta Scientific Medical Sciences 4.8 (2020): .




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





Contact US