Efficacy of Propofol and Fentanyl in Reducing Emergence Agitation in Pediatric Patients after Sevoflurane Anesthesia: A Prospective Comparative Study

Abstract

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%). ....