Prospective, Randomized Comparisons of Induction of Anesthesia with Ketamine, Propofol and Sevoflurane for Quality of Recovery from Short Sevoflurane Anesthesia in Pediatric PatientsReportar como inadecuado




Prospective, Randomized Comparisons of Induction of Anesthesia with Ketamine, Propofol and Sevoflurane for Quality of Recovery from Short Sevoflurane Anesthesia in Pediatric Patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background: Emergence agitation EA after sevoflurane anesthesia is common in children. When rapid intravenous induction of general anesthesia is indicated in a brief procedure, the induction agent can reduce the incidence of EA after sevoflurane anesthesia. The aim of this study was to compare the efficacy of intravenous induction with ketamine and propofol for reducing EA in children after short sevoflurane anesthesia. Methods: Children aged 2 to 6 years who were scheduled to undergo inguinal hernia repair were randomly divided into 3 groups to receive 2 mg-kg ketamine iv, 3 mg-kg propofol iv, or inspired concentration of 8% sevoflurane for induction of anesthesia. After a laryngeal mask airway LMA insertion, a caudal block was performed in all children. Anesthesia was maintained with 1.5% sevoflurane and 65% nitrous oxide in oxygen with spontaneous ventilation. The recovery characteristics were recorded and EA were evaluated by using the Pediatric Anesthesia Emergence Delirium PAED scale. Results: One hundred and twenty children were enrolled and randomized to treatment. Children who received ketamine induction had higher incidence of EA than those who received propofol 42% vs 16%, P < 0.05 and showed delayed recovery 32 ± 9 min as compared with those who received propofol or sevoflurane 22 ± 8 min and 20 ± 7 min, respectively, P < 0.05. The mean peak PAED score was significantly lower in children who received propofol induction 6.8 ± 4.0, P < 0.05 than ketamine 11.8 ± 4.1 or sevoflurane 11.6 ± 3.8. Conclusions: Intravenous induction with ketamine does not prevent the incidence of EA and delays recovery. Induction with propofol improves the quality of recovery by reducing the incidence of EA and provides a safe and early recovery.

KEYWORDS

Pediatric Anesthesia, Emergence Agitation, Sevoflurane, Propofol, Ketamine

Cite this paper

Nakayama, S. , Furukawa, H. and Yanai, H. 2015 Prospective, Randomized Comparisons of Induction of Anesthesia with Ketamine, Propofol and Sevoflurane for Quality of Recovery from Short Sevoflurane Anesthesia in Pediatric Patients. Open Journal of Anesthesiology, 5, 163-169. doi: 10.4236-ojanes.2015.57029.





Autor: Shin Nakayama, Hajime Furukawa, Hiromune Yanai

Fuente: http://www.scirp.org/



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