A Single Dose Of Propofol And Ketamine For The Prevention Of Emergence Agitation In Children During Sevoflurane Anesthesia

Objective:To evaluate the preventive effect of propofol and ketamine on emergence agitation in children during sevoflurane anesthesia . Methods:Sixty children aged 4 to 7 years old undergoing selective tonsillectomy and (or) adenoidectomy, American Society of Anesthesiologists [ASA] I or II, were divided into 3 groups , group K(n=20) : sevoflurane plus A Single Dose of ketamine; group P(n=20) : sevoflurane plus A Single Dose of propofol; group S(n=20) : sevoflurane control group. Patients in three groups were all premedicated with atropine 0.01mg·kg-1 i.m.30min before admission into the operating room , Parents were allowed to be present during induction, non-invasive blood pressure, ECG and aeterial oxygen saturation were monitored. Anesthesia was induced with sevoflurane, after disappearance of eyelashes reflex , an intravenous line was inserted, all patients received midazolam(0. 05mg·kg-1),fentanyl(4μg·kg- 1) vecuronium(0. 1 mg·kg-1)before tracheal intubation, anesthesia was maintained with sevoflurane, Children in the ketamine group (Group K) were given 0.25 mg·kg-1 ketamine 10 min before surgery end, Children in the propofol group (Group P) were given 1mg·kg-1 propofol and Children in the placebo group (Group S) were given an equal volume of saline and served as a control group. The times of surgery,anesthesia,extubation and PACU were recorded . The comfort score before extubation and the incidence of emergence agitation were observed in 1～30 minutes after extubation Adverse effects were recorded as well . Results:The incidence of emergence agitation was higher in S Group than that in K Group and P Group ( P < 0.05) at the time of 10 min, 15 min, 20 min, 25 min after extubation ,The incidence of emergence agitation was significantly higher in S Group than that in P Group ( P <0.01) at the time of 10 min, 15 min, And there was no significant difference during P Group and K Group at different check-point ( P >0.05) . The satisfaction rate of the sedation in three group were 50% 80%,25% respectively, The satisfaction rate was higher in K Group and P Group than that in S Group ( P <0.05) ,The satisfaction rate was significantly higher in P Group than that in S Group ( P <0.01) . The time stay at PACU was significantly longer in S Group than that in K Group and P Group ( P < 0.01),there was significant difference during K Group and S Group . Conclusion:We conclude that the addition of ketamine 0.25 mg·kg-1 or propofol 1mg·kg-1 can decrease the incidence of emergence agitation in children after sevoflurane general anesthesia.