Introduction: Emergence agitation is a common postoperative phenomenon in pediatric patients that can lead to adverse outcomes. Propofol and fentanyl have been used for its management, but their comparative efficacy remains unclear. This study aimed to compare the efficacy of propofol and fentanyl in reducing emergence agitation in pediatric patients after Sevoflurane anesthesia. Methods: This prospective observational study was conducted at the Pediatric Anesthesia Department of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh over a 6-month period. 160 pediatric patients between the ages of 2-8 who underwent elective surgery and experienced emergence agitation under Sevoflurane anesthesia were selected. Patients with certain medical conditions or allergies were excluded. The participants were randomly divided into two groups: one receiving propofol and one receiving fentanyl. Anesthesia was induced with 8% sevoflurane, and data was collected and analyzed to compare the efficacy of propofol and fentanyl in reducing emergence agitation in pediatric patients. Ethical approval and informed consent were obtained. Result: Both groups had similar mean age and weight, with the propofol group having a mean age of 3.6 (SD 2.8) years and a mean weight of 15.7 (SD 3.3) kg, while the fentanyl group had a mean age of 3.7 (SD 2.5) years and a mean weight of 15.9 (SD 3.6) kg. Most subjects were male, with 75% in the propofol group and 57.5% in the fentanyl group. The mean duration of anesthesia was similar, with the propofol group at 63.5 (SD 14.8) minutes and the fentanyl group at 61.6 (SD 11.9) minutes. The mean PAED score was lower in the propofol group (4.3, SD 3.2) compared to the fentanyl group (4.9, SD 3.5). Airway obstruction and laryngospasm were less frequent in the propofol group (2.5% and 1.25%, respectively) compared to the fentanyl group (6.25% each), and nausea/vomiting was lower in the propofol group (6.25%) compared to the fentanyl group (26.25%). ....
Introduction: EA is characterized by agitation, inconsolable sobbing, disorientation, delusions, and hallucinations, decreased cognition and memory. Sevoflurane is widely used as an anesthetic agent for children because of its less pungent nature, lower solubility but it has a greater incidence of EA in preschool aged children. Propofol is a hypnotic amnestic agent with a short duration of action, commonly used for sedation, induction, and maintaining anesthesia and it has been used to prevent Emergence agitation. Aim of the Study: The aim of this study was to determine the efficacy of low dose propofol in reducing the incidence of EA at the end of face-mask sedation with sevoflurane. Methods: This was a prospective observational study and was conducted in the Department of Pediatric Anesthesia of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh during the period from July, 2021 to December, 2021.In our study we took 220 children operated for hernia were randomized into two groups – Group A (Control group, n=110) and Group B (Propofol group, n= 110). Result: In total 220 patients from both the groups completed the study. In our study we found the mean age in group A & B was 6.3 ± 1.6 & 6.1 ± 1.9 years respectively. The mean PAED score was 14.41 ± 2.59 & 9.83 ± 3.51, the mean emergence time was 7.1 ± 2.0 & 13.4 ± 2.5, time in PACU was 44.5 ± 5.9 & 46.6 ± 7.6 mins in control & propofol group respectively. In contrast to the control group, no patient in the propofol group experienced EA beyond 15 or 20 minutes of emergence. Conclusion: In our study, we found that 0.5mg,/kg propofol was effective in preventing Emergence Agitation in children underwent herniotomy with caudal block and who’s sedation were maintained with sevoflurane.
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