title: Use of propofol and emergence agitation in children: a literature review.
abstract: Emergence agitation (EA) is an important issue in pediatric anesthesia. This phenomenon arises more frequently with the use of inhalational agents. Three commonly used general anesthesia techniques in children were evaluated as to the associated incidence of emergence reactions. An extensive literature review was performed to evaluate these anesthetic practices and the occurrence of EA in young children. Relevant literature was obtained from multiple sources, including professional journals, professional websites, and textbooks. Three categories of anesthesia techniques were reviewed: sevoflurane inhalational general anesthetic, Emerpropofol as an adjunct to sevoflurane general anesthetic, and propofol total intravenous anesthesia (TIVA) techniques. Several variables within each category were evaluated with respect to the outcome of EA: prevention, intraoperative adjuncts, type of surgery, and patient-related factors. According to the literature evidence base, there is an advantage to either propofol TIVA or adjunctive propofol with sevoflurane (compared with sevoflurane alone). We conclude, based on the current evidence, that the use of propofol is associated with a reduction in the incidence of emergence agitation.
authors.affiliation: Nurse Anesthesia Program, Western Carolina University, Candle, NC, USA.
authors.forename: K Logan
authors.initials: KL
authors.lastname: Key
authors.forename: Christopher
authors.initials: C
authors.lastname: Rich
authors.forename: Claire
authors.initials: C
authors.lastname: DeCristofaro
authors.forename: Shawn
authors.initials: S
authors.lastname: Collins
mesh_terms: D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D000771:Anesthesia, Intravenous / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D015984:Causality; D002648:Child; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D055317:Evidence-Based Practice; D006801:Humans; D008738:Methyl Ethers / Q000627:therapeutic use; D009719:Nurse Anesthetists; D015742:Propofol / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012107:Research Design; D012720:Severity of Illness Index; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol