title: Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys.
abstract: BACKGROUND
  In the authors' clinical experience, preschool children are more likely to show delirium after sevoflurane than are older children.
  
  
  METHODS
  Sixty-three preschool boys aged 3-5 yr (classified as American Society of Anesthesiologists [ASA] physical status I), and 53 school-age boys aged 6-10 yr (ASA physical status I) who underwent minor urologic surgery were randomly assigned to receive either halothane or sevoflurane, thus creating four groups: preschool-halothane (n = 32), preschool-sevoflurane (n = 31), school-halothane (n = 27), and school-sevoflurane (n = 26). Anesthesia was induced by inhalation of halothane or sevoflurane in oxygen and was maintained at 1 minimum alveolar concentration of each agent throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5-1.0 ml/kg 0.25% plain bupivacaine and topical infiltration with 3-5 ml 1% lidocaine were provided for all patients. Recovery characteristics and incidence of delirium on emergence were compared among the four groups.
  
  
  RESULTS
  Two patients in the preschool-halothane group, one in the preschool-sevoflurane group, and one in the school-halothane group were excluded from the comparison because of insufficient analgesia or agitation before induction. In both age groups, the time to emergence from sevoflurane was significantly faster (about 3 min) than from halothane. The incidence of delirium during recovery in the preschool-sevoflurane group (40%) was significantly greater than that in the other groups (preschool-halothane, 10%; school-halothane, 15.4%; school-sevoflurane, 11.5%).
  
  
  CONCLUSIONS
  Sevoflurane provided quicker emergence and early recovery compared with halothane, but the incidence of delirium was greater in preschool boys after sevoflurane.
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Aono
authors.forename: W
authors.initials: W
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Mamiya
authors.forename: E
authors.initials: E
authors.lastname: Takimoto
authors.forename: M
authors.initials: M
authors.lastname: Manabe
mesh_terms: D000367:Age Factors; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003693:Delirium / Q000139:chemically induced*; D004987:Ethers / Q000009:adverse effects*; D006221:Halothane / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008738:Methyl Ethers; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane