Sevoflurane <i>versus</i>  Halothane: Postoperative Maladaptive Behavioral Changes

Kain, Zeev N.; Caldwell‐Andrews, Alison A.; Weinberg, Megan E.; Mayes, Linda C.; Wang, Shuming; Gaal, Dorothy; Saadat, Haleh; Maranets, Inna

doi:10.1097/00000542-200504000-00005

Cited by 61 publications

(35 citation statements)

References 21 publications

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“…46,47 Three studies were randomized clinical trials. 24,42,43 The 24 studies were conducted between 1996 and 2011. The smallest study included 11 patients, and the largest included 169 patients.…”

Section: Sleepmentioning

confidence: 99%

“…The smallest study included 11 patients, and the largest included 169 patients. In 12 studies there was a control group 22,[24][25][26][27]32,[40][41][42][43]46,47 ; 5 of these studies included healthy controls. 22,26,27,40,41 In 23 of the 24 studies, total sleep time/nighttime sleep was assessed by actigraphy ( Table 1).…”

Section: Sleepmentioning

confidence: 99%

“…There were 5 studies in the ambulatory setting, [39][40][41][42][43] where patients underwent orthopedic, plastic, ophthalmic, or minor general surgical procedures. Three of these studies [39][40][41] defined sleep impairment as a reduction of one standard deviation in sleep efficiency measured by actigraphy.…”

Section: Ambulatory Surgerymentioning

confidence: 99%

“…In the adult study, surgical patients also had an increased number of awakenings longer than 5 minutes compared with the healthy controls. 41 In a double-blinded randomized clinical trial, 42 halothane anesthesia was compared with sevoflurane anesthesia. The study showed no difference between the groups for any of the sleep parameters after ambulatory surgery (total sleep time, sleep efficiency, or number of awakenings).…”

Section: Ambulatory Surgerymentioning

confidence: 99%

See 3 more Smart Citations

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Madsen

Rosenberg²,

Gögenur³

2013

Journal of Clinical Sleep Medicine

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Study Objectives: Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. methods: A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. Results: Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep effi ciency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery.Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. Conclusion: Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery. keywords: Actigraphy, surgery, sleep disturbances, sleepwake rhythm, and activity Citation: Madsen MT; Rosenberg J; Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013;9(4):387-394.http://dx.doi.org/10.5664/jcsm.2598 R e v I e W A R T I C l e D isturbed sleep and sleep-wake rhythms represent a major problem for patients after surgery 1 and may result in prolonged postoperative convalescence, 2 cardiovascular morbidity, 3-5 cognitive dysfunction, 6,7 and impaired immune function. [8][9][10][11] Furthermore, improved morbidity and mortality has been correlated with a more marked rest-activity rhythm. 12,13The golden standard for measuring sleep is polysomnography (PSG). Although ambulatory devices have been developed the method includes multiple electrodes, resulting in reduced mobility and discomfort.14 The analysis of a PSG recording is also resource demanding, 15 and there exists no automatic analysis scoring system with suffi cient reliability.16 An actigraph, which is a small wrist-worn device, can be used to measure sleep, circadian rhythm, activity rhythm, and activity in general. 17 The advantages of actigraphy are high level of mobility, 14 the possibility of measuring over longer periods of time (days to months), 18 low cost, 18 and minimal data editing required for data analysis. 15,19 Actigraphy has been validated against polysomnography with high levels of sensitivity and specifi city in various nonsurgical patient populations. 17,18,20,21 In this systematic review, we present an overview of studies where actigraphy has been used to describe sleep and sleep-wake rhythms in relation to surgery, including patients undergoing cardiac surgery, general surgery, and ambulatory surgery. The strengths and weaknesses of actigraphy...

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Section: Sleepmentioning

confidence: 99%

Section: Sleepmentioning

confidence: 99%

Section: Ambulatory Surgerymentioning

confidence: 99%

Section: Ambulatory Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Madsen

Rosenberg²,

Gögenur³

2013

Journal of Clinical Sleep Medicine

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“…[29][30][31] However, other authors have observed that there was no significant difference between the use of sevoflurane and the use of halothane in the incidence of emergence agitation or behavioral changes during the postoperative period or sleep disorders in children. 32 Thus, faced with this evidence, it is clear that inhaled anesthetics, particularly sevoflurane and desflurane, are potential trigger factors of emergence agitation, but that there is not yet any definitive explanation for the triggering cause.…”

Section: Inhaled and Intravenous Anestheticsmentioning

confidence: 99%

Agitação no despertar da anestesia em crianças: aspectos atuais

Silva¹,

Braz²,

Módolo³

2008

J. Pediatr. (Rio J.)

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Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia. Summary of the findings:This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment. Conclusion:No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.

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Effects of sevoflurane versus other general anaesthesia on emergence agitation in children

Costi

Cyna

Ahmed

et al. 2014

Cochrane Database of Systematic Reviews

141

133

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Propofol, halothane, alpha-2 agonists (dexmedetomidine, clonidine), opioids (e.g. fentanyl) and ketamine reduce the risk of EA compared with sevoflurane anaesthesia, whereas no clear evidence shows an effect for desflurane, isoflurane, midazolam premedication and parental presence at emergence. Therefore anaesthetists can consider several effective strategies to reduce the risk of EA in their clinical practice. Future studies should ensure adequate analgesia in the control group, for which pain may be a contributing or confounding factor in the diagnosis of EA. Regardless of the EA scale used, it would be helpful for study authors to report the risk of EA, so that this might be included in future meta-analyses. Researchers should also consider combining effective interventions as a multi-modal approach to further reduce the risk of EA.

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Sevoflurane versus Halothane: Postoperative Maladaptive Behavioral Changes

Abstract: The authors found no increased incidence of emergence delirium, maladaptive postoperative behavior changes, or sleep disturbances in children undergoing anesthesia with sevoflurane as compared with halothane.

Cited by 61 publications

References 21 publications

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Agitação no despertar da anestesia em crianças: aspectos atuais

Effects of sevoflurane versus other general anaesthesia on emergence agitation in children

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