The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children.
BACKGROUND
Laryngospasm is a well-known problem typically occurring immediately following tracheal extubation. Propofol is known to inhibit airway reflexes. In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children.


METHODS
After approval from the Institutional Ethics Committee and informed parental consent, we enrolled 120 children ASA physical status I and II, aged 3-14 years who were scheduled to undergo elective tonsillectomy with or without adenoidectomy under standard general anesthesia. Before extubation, the patients were randomized and received in a blinded fashion either propofol 0.5 mg.kg(-1) or saline (control) intravenously. Tracheal extubation was performed 60 s after administration of study drug, when the child was breathing regularly and reacting to the tracheal tube.


RESULTS
Laryngospasm was seen in 20% (n = 12) of the 60 children in the control group and in only 6.6% (n = 4) of 60 children in the propofol group (P < 0.05).


CONCLUSIONS
During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg.kg(-1)) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy.
Batra
Yatindra Kumar
YK
Department of Anaesthesia and Intensive Care, Al Sabah Hospital, Kuwait. ykbatra@glide.net.in
Ivanova
Maya
M
Ali
Syed Shujat
SS
Shamsah
Mohammed
M
Al Qattan
Abdul Raheem
AR
Belani
Kumar G
KG
D000233:Adenoidectomy; D000293:Adolescent; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D004311:Double-Blind Method; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007442:Intubation, Intratracheal; D007826:Laryngismus / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D014068:Tonsillectomy
D006993:Hypnotics and Sedatives; D015742:Propofol