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Journal of Anesthesia
Published in: Journal of Anesthesia 4/2023

16-05-2023 | Strabismus | Original Article

Subanesthetic-dose propofol infusion for preventing emergence agitation in children: a retrospective observational study

Authors: Tomoaki Miyake, Yoshihisa Miyamoto, Nobuhito Nakamura

Published in: Journal of Anesthesia | Issue 4/2023

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Abstract

Purpose

Anesthesia maintenance using propofol and a propofol bolus dose at the end of surgery have been shown to prevent emergence agitation (EA). However, the preventive effect of subanesthetic propofol infusion during sevoflurane anesthesia on EA remains unknown. We aimed to evaluate the effect of subanesthetic propofol infusion on EA in children.

Methods

We retrospectively compared the incidences of severe EA requiring pharmacological intervention in children who underwent adenoidectomy, tonsillectomy with or without adenoidectomy, or strabismus surgery between maintenance with sevoflurane alone (sevoflurane group) and maintenance with subanesthetic propofol with sevoflurane (combination group). A multivariable logistic regression model adjusted for confounders was used to assess the association between anesthesia methods and the occurrence of EA. Additionally, we estimated the direct effect of anesthesia methods by a mediation analysis, excluding the indirect effects of intraoperative fentanyl and droperidol administration.

Results

Among 244 eligible patients, 132 and 112 were in the sevoflurane and combination groups, respectively. The crude incidence of EA was significantly lower in the combination group (17.0% [n = 19]) than in the sevoflurane group (33.3% [n = 44]) (P = 0.005). After adjusting for confounders, the incidence of EA was still significantly lower in the combination group (adjusted odds ratio [aOR]: 0.48, 95% confidence interval [CI] 0.25–0.91). The mediation analysis revealed a direct association of anesthesia methods with a lower EA incidence in the combination group (aOR: 0.48, 95% CI 0.24–0.93) than in the sevoflurane group.

Conclusion

Subanesthetic propofol infusion may effectively prevent severe EA requiring the administration of opioids or sedatives.
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Metadata
Title
Subanesthetic-dose propofol infusion for preventing emergence agitation in children: a retrospective observational study
Authors
Tomoaki Miyake
Yoshihisa Miyamoto
Nobuhito Nakamura
Publication date
16-05-2023
Publisher
Springer Nature Singapore
Published in
Journal of Anesthesia / Issue 4/2023
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-023-03201-8

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