title: Effects of low-dose propofol vs ketamine on emergence cough in children undergoing flexible bronchoscopy with sevoflurane-remifentanil anesthesia: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Operating room, postoperative recovery area.
  
  
  METHODS
  Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL.
  
  
  METHODS
  After discontinuation of anesthetics at the end of FOBL, patients were randomly divided into 3 groups: in group K, children were administered 0.5 mg/kg of ketamine; in group P, 0.5 mg/kg of propofol; and in group C, 0.1 mL/kg of normal saline.
  
  
  METHODS
  Anesthesia time, procedure time, emergence time, and recovery time were recorded. Coughing and delirium scores were recorded as the patient fully emerged from anesthesia (time 0) and 5, 10, 15, and 20 minutes later.
  
  
  RESULTS
  The percentage of children with moderate or severe cough during emergence was similar in all groups. Mean delirium scores at emergence (T0) were significantly lower in group K than those in group P and in group C (P = .0001 and P = .02). Mean delirium score at 5 minutes in group K (6 [5-10]) was significantly lower than that of group C (P = .02) and similar to that of group P. The recovery time of group K was significantly longer than that of group C and group P (P = .01 and P = .03, respectively).
  
  
  CONCLUSIONS
  Ketamine or propofol given at the end of sevoflurane-remifentanil general anesthesia in children undergoing FOBL did not decrease cough more than normal saline during the emergence period. Ketamine and propofol, compared to normal saline, had a beneficial effect on decreasing the incidence of emergence delirium. Ketamine lengthened recovery time.
authors.affiliation: Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey. Electronic address: ozturktulun@yahoo.com.
authors.forename: Tulun
authors.initials: T
authors.lastname: Ozturk
authors.affiliation: Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Acıkel
authors.affiliation: Department of Pediatric Pulmonology, University of Celal Bayar, Manisa, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Yılmaz
authors.affiliation: Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
authors.forename: Ismet
authors.initials: I
authors.lastname: Topçu
authors.affiliation: Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
authors.forename: Eralp
authors.initials: E
authors.lastname: Çevıkkalp
authors.affiliation: Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Yuksel
mesh_terms: D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D018893:Bronchoalveolar Lavage / Q000009:adverse effects*; D001999:Bronchoscopy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D000071257:Emergence Delirium / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*; D000077208:Remifentanil; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D016194:Receptors, N-Methyl-D-Aspartate; D000077149:Sevoflurane; D007649:Ketamine; D000077208:Remifentanil; D015742:Propofol
keywords: Bronchoscopy; Cough; Ketamine; Pediatric; Propofol