title: Comparing incidence of emergence delirium between sevoflurane and desflurane in children following routine otolaryngology procedures.
abstract: BACKGROUND
  Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated Pediatric Emergence Delirium (PAED) Scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat surgery.
  
  
  METHODS
  Forty-six children aged 12 months-7 years were randomly assigned to receive either sevoflurane (N.=23) or desflurane (N.=23) for maintenance of general anesthesia. All patients were extubated awake in the OR, and upon arrival in the PACU, PAED scores were assessed every 15 minutes until discharged. In addition to PAED scores, time to tracheal extubation, emergence behavior, pain scores, and recovery complications were recorded.
  
  
  RESULTS
  We found no significant difference in incidence of ED or peak PAED scores between sevoflurane and desflurane groups (12 [0-18] versus 12 [0-20]; P=0.79). There were no significant differences between desflurane and sevoflurane with respect to incidence of adverse events, such as nausea, vomiting, laryngospasm, or excessive secretions.
  
  
  CONCLUSIONS
  In conclusion, the use of desflurane for maintenance of anesthesia did not significantly affect the incidence or duration of ED when compared to sevoflurane. However, desflurane did not demonstrate any increase in adverse events, which may support its routine use in this patient population.
authors.affiliation: College of Medicine, University of Central Florida, Orlando, FL, USA - jdrisc@knights.ucf.edu.
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Driscoll
authors.affiliation: Department of Anesthesiology, Nemours Children's Hospital, Orlando, FL, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Bender
authors.affiliation: Department of Anesthesiology, Nemours Children's Hospital, Orlando, FL, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Archilla
authors.affiliation: Department of Anesthesiology, Nemours Children's Hospital, Orlando, FL, USA.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Klim
authors.affiliation: Division of Bioinformatics, Alfred I. DuPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Md J
authors.initials: MJ
authors.lastname: Hossain
authors.affiliation: Burrell College of Osteopathic Medicine, New Mexico State University, Las Cruces, NM, USA.
authors.forename: George
authors.initials: G
authors.lastname: Mychaskiw
authors.affiliation: Division of Otolaryngology, Department of Surgery, Nemours Children's Hospital, Orlando, FL, USA.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Wei
mesh_terms: D060666:Airway Extubation; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D000077335:Desflurane / Q000009:adverse effects*; D000071257:Emergence Delirium / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D000077149:Sevoflurane / Q000009:adverse effects*; D016037:Single-Blind Method
chemical_list: D018685:Anesthetics, Inhalation; D000077149:Sevoflurane; D000077335:Desflurane