Emergence Agitation After Sevoflurane Versus Propofol in Pediatric Patients

Hemodynamic differences between propofol–remifentanil and sevoflurane anesthesia for repair of cleft lip and palate in infants

“…Agitation does not appear to be a problem in any of the groups as previously found after sevoflurane (10,12). One study suggests that agitation and excitement during emergence are manifestations of acute pain and anxiety (26) and other studies have shown that sufficient pain relief diminishes agitation after sevoflurane anesthesia (14,15).…”

Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia

“…However, even in pain‐free patients, postoperative agitation is common in preschool children after sevoflurane (30), desflurane (67), and isoflurane (68,69) based anesthetics. Pediatric anesthesiologists should all be familiar with strategies for the prevention and treatment of agitation; the most evident option would be, however, to avoid inhalational agents for maintenance at all, and to use propofol instead (33,70). This increases patient’s comfort, parental satisfaction, and reduces the recovery room nurses’ workload.…”

Bispectral index under propofol anesthesia in children: a comparative randomized study between TIVA and TCI

“…In adults, the concept of total intravenous anesthesia (TIVA) has been widely developed with propofol, while in children, because of an easy administration and rapid reversibility, inhalational anesthesia is still the most frequently used . Nevertheless, propofol anesthesia may present clinical advantages: recent studies have demonstrated that propofol anesthesia in children, as in adults, is associated with a major reduction in the incidence of postanesthetic nausea and vomiting and with a decrease in emergence agitation episodes compared to volatile agents . Moreover, propofol limits the risk of electro‐encephalographic epileptoïd signs which may occur under high concentrations of sevoflurane .…”