A comparison of single dose dexmedetomidine with propofol for the prevention of emergence delirium after desflurane anaesthesia in children

Makkar, Jeetinder Kaur; Bhatia, Nidhi; Bala, Indu; Dwivedi, Deepak; Singh, Preet Mohinder

doi:10.1111/anae.13230

Cited by 44 publications

(41 citation statements)

References 37 publications

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“…The sample size of the current study was based on the previous investigation on the ED. The incidence of ED of the control group (without intervention) was 40.6%, and the reduction of 30% (from 40.6% to 10.6%) in the incidence of ED was considered to be clinically significant. A sample size of 43 children per group was determined with a significance level of 0.05 (α = 0.05) and a power of 80 percent (β = 0.20), allowing for a 10% dropout rate.…”

Section: Methodsmentioning

confidence: 99%

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Ryu

Yoo

et al. 2018

Pediatric Anesthesia

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Summary Background and Aims An immersive virtual reality tour of the operating theater could reduce preoperative anxiety. This study was designed to determine whether a preoperative immersive virtual reality tour demonstrates a reduction in emergence delirium through reducing the preoperative anxiety in children undergoing general anesthesia. Methods Eighty‐six children were randomly allocated into either the control or virtual reality group. The control group received conventional education regarding the perioperative process. The virtual reality group watched a 4‐minute virtual reality video showing the operating theater and explaining the perioperative process. Incidence and severity of emergence delirium were the main outcomes. Secondary outcomes included preoperative anxiety using modified Yale Preoperative Anxiety Scale and postoperative behavioral disturbance. Results Eighty children completed the final analysis (control group = 39, virtual reality group = 41). The incidence (risk ratio [95% CI]: 1.1 [0.5‐2.8], P = 0.773) and severity of emergence delirium (mean difference [95% CI]: −0.2 [−2.7 to 2.2], P = 0.791) were similar in the two groups. After the intervention, children in the virtual reality group had a significantly lower modified Yale Preoperative Anxiety score than those in the control group (mean difference [95% CI]: 9.2 [0.3‐18.2], P = 0.022). No difference was observed regarding postoperative behavioral disturbance between the two groups at postoperative 1 day (mean difference [95% CI]: −0.1 [−0.3 to 0.1], P = 0.671) and 14 day (mean difference [95% CI]: −0.0 [−0.1 to 0.0], P = 0.329). Conclusion Preoperative immersive virtual reality tour of the operating theater did not reduce the incidence and severity of emergence delirium, although it was effective in alleviating preoperative anxiety in children.

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Section: Methodsmentioning

confidence: 99%

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Ryu

Yoo

et al. 2018

Pediatric Anesthesia

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“…Fentanyl and dexmedetomidine injection before end of surgery also shown reduces EA. (Abdelhalim & Alarfaj 2013, Makkar et al 2016.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia

Andriyanto¹,

Utariani²,

Hanindito³

et al. 2019

FMI

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Post anesthesia agitation is common problem in pediatric post anesthesia care unit. The incidences range from 10 to 80%. EA has been described as a dissociated state of consciousness in which the child is inconsolable, irritable, and uncooperative typically thrashing, crying, moaning or incoherent. This study was done to determine the incidence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. This descriptive and analytic study was performed on 105 pediatric patient aged 1-12 years that underwent general anesthesia for various elective diagnostic and surgeries at Dr. Soetomo Hospital between January and February 2016. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium (PAED) scale. The factors that linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software with logistic regression. p - values less than 0.05 were considered as significant. Forty two (40%) children had Emergence Agitation. Preoperative anxiety (p = 0.006) and Pain (p=0.035) were associated with higher rates of post anesthetic emergence agitation. This study identified preoperative anxiety and pain as risk factors, which are associated with emergence agitation in children. To minimize the incidence of post anesthetic emergence agitation, these risk factors should be considered in the routine care by anesthetist.

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“…Однако установлены другие факторы, в том числе фармакологические, влияющие на частоту и выраженность этого осложнения. Так, например, включение в протокол анестезии однократного болюсного введения таких препаратов, как пропофол или дексмедетомидин, снижает частоту развития посленаркозной ажитации [17]. Применение фентанила в качестве анальгетического компонента анестезии также снижает частоту и выраженность эпизодов посленаркозного возбуждения [18].…”

Section: результатыunclassified

Comparative evaluation of desflurane and sevoflurane anesthesia during surgical correction of vertebral and spinal cord injury in children

Kozyrev

Сергеевич²,

Aleksandrovich

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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Introduction. Currently, inhaled third-generation anesthetic agents, such as sevoflurane and desflurane, are commonly used in pediatric practice. Their properties and efficiencies are studied in detail. Information about the effectiveness and safety of these drugs as emergency anesthesia in children is very limited; there are no comparative studies. The aim of this study was to conduct a comparative evaluation of desflurane and sevoflurane to maintain anesthesia during the surgical correction of vertebral and spinal cord injury in children. Material and methods. This study included seventy-four 12–18-year-old patients (mean age, 14 years) who underwent immediate surgical correction of unstable fractures of the thoracolumbar and lumbar spine at the Turner Scientific Research Institute for Children’s Orthopedics between 2015 and 2017. The patients were categorized into two groups: group D, in which anesthesia was maintained with desflurane (35 patients), and group C, in which anesthesia was maintained with sevoflurane (39 patients). The following parameters were studied: systolic, diastolic, and average blood pressure (BP); heart rate (HR); respiratory recovery time; time to extubation; time to instruction completion; and presence of complications intraoperatively and within 24 h after surgery, including pronounced intraoperative hypotension, bradypnea, and desaturation (SpO2 < 95%) in the postextubation period, agitation, nausea, vomiting, and measured blood loss. Results. A comparative evaluation of the investigated parameters revealed that the systolic, diastolic, and average BP and HR in both groups did not exceed the limits of acceptable values. The results of the intraoperative monitoring of capillary blood parameters in all patients were within the reference range and did not differ significantly between groups. An analysis of the indicators reflecting the rate of awakening revealed that all stages of the termination of anesthesia were performed more quickly in group D. There was a comparable number of postoperative nausea and vomiting episodes in both groups. Group C displayed a high incidence of postoperative agitation. There were no related adverse respiratory effects in group D, whereas three patients reported such effects in group C. Conclusions. The use of desflurane and sevoflurane provides a favorable hemodynamic profile intraoperatively and is not accompanied with the development of clinically significant side effects. Desflurane reduces the probability of certain adverse effects in the immediate postoperative period, provides a faster awakening, and has the possibility of reliable assessment of neurological status after surgery.

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A comparison of single dose dexmedetomidine with propofol for the prevention of emergence delirium after desflurane anaesthesia in children

Cited by 44 publications

References 37 publications

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial

Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia

Comparative evaluation of desflurane and sevoflurane anesthesia during surgical correction of vertebral and spinal cord injury in children

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