Emergence Delirium in Pediatric Age Group: Comparison Between Sevoflurane and Intravenous Anesthesia in Hypospadias Repair: A Randomized Clinical Trial
Overview
- Phase
- Not Applicable
- Intervention
- sevoflurane
- Conditions
- Emergence Delirium
- Sponsor
- Benha University
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Emergence delirium
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Emergence agitation (EA), a phenomenon observed at the time of recovery from general anesthesia (GA).The cause of ED appears to be multifactorial in origin. Use of volatile anesthetics, prolonged duration and type of surgery, pain, and rapid emergence are some factors known to increase its incidence
Detailed Description
The pathogenesis of postoperative EA is still undefined, but sevoflurane has intrinsic effects that may share in emergence agitation like its different electroencephalogram pattern from halothane, and its degradation to inorganic fluoride ions and compound A which may have a role in the occurrence of EA Sevoflurane now is the inhalational anaesthetic agent of choice for pediatrics, as it is non-pungent, with minimal airway irritation characters, and its cardiac adverse effects are minimal like cardiac depression and dysrhythmias. Total intravenous anesthesia (TIVA) using propofol and fentanyl appears to have a smooth recovery profile
Investigators
Ramy Mousa
Professor of Anesthesia and surgical ICU department, Faculty of Medicine, Benha University, Egypt
Benha University
Eligibility Criteria
Inclusion Criteria
- •ages 1 to 8 years
- •American society of anesthesiologists (ASA) physical status I and II, scheduled for hypospadias repair
Exclusion Criteria
- •children with a history of active airway disease,
- •sleep apnoea, developmental delay,
- •psychological,
- •neurological disorder,
- •cardiovascular abnormality or requirement of post-operative ventilation,
- •hepatic impairment, and renal insufficiency, with active upper respiratory tract infection
Arms & Interventions
sevoflurane group
Anesthesia was maintained with sevoflurane (1-1.2 MAC) with oxygen /air 1:1
Intervention: sevoflurane
Propofol group
Anesthesia was maintained continuous infusion of 100-400 mcg/kg /min of propofol and fentanyl 0.1 ug / kg/ min with oxygen /air 1:1
Intervention: propofol
Outcomes
Primary Outcomes
Emergence delirium
Time Frame: 24 hours
The pediatric anesthesia emergence delirium (PAED) scale. Each must be evaluated as not at all, just a little, quite a bit, very much, or extremely, where the first three items to be scored reversely (4 = not at all, 0 = extremely) while the last two items to be scored regularly.
Secondary Outcomes
- FLACC(Postoperatively at 24 hours)