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      KCI등재 SCOPUS SCIE

      소아에서 Bispectral Index 감시하에 Sevoflurane, Desflurane, Propofol을 이용한 전신마취 후 발생하는 각성시 흥분의 비교 = Comparison of emergence agitation between sevoflurane, desflurane, and propofol with bispectral index monitoring in pediatric anesthesi

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      https://www.riss.kr/link?id=A104327696

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      다국어 초록 (Multilingual Abstract)

      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indicates emergence agitation with propofol is also frequent. We tested the hypothesis that depth of anesthesia could lead to frequent emergence agitation with propofol.
      Methods: Sixty children, ASA 1, aged 3−12 years, undergoing general anesthesia for adenotonsillectomy were randomized to receive maintenance anesthesia with sevoflurane, desflurane, or propofol. The bispectral index was monitored and maintained within 40−65. Time to extubation, duration of postanesthetic care units stay, bispectral index just before stopping the anesthetic agent, anesthetic time, early and late postoperative Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) were compared among the 3 groups. Data were analyzed using ANOVA (demographic data, measured time interval, BIS) and Kruskal-Wallis test (PAEDS and CHEOPS). The Spearman correlation coefficient was used to confirm the correlation between the two scales.
      Results: Although desflurane resulted in the fastest extubation, other scales were not statistically different. PAEDS and CHEOPS for sevoflurane showed a positive correlation in the early recovery period, but desflurane and propofol did not.
      Conclusions: With the same depth of anesthesia, emergence agitation among desflurane, sevoflurane, and propofol was not different in children.
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      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indi...

      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indicates emergence agitation with propofol is also frequent. We tested the hypothesis that depth of anesthesia could lead to frequent emergence agitation with propofol.
      Methods: Sixty children, ASA 1, aged 3−12 years, undergoing general anesthesia for adenotonsillectomy were randomized to receive maintenance anesthesia with sevoflurane, desflurane, or propofol. The bispectral index was monitored and maintained within 40−65. Time to extubation, duration of postanesthetic care units stay, bispectral index just before stopping the anesthetic agent, anesthetic time, early and late postoperative Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) were compared among the 3 groups. Data were analyzed using ANOVA (demographic data, measured time interval, BIS) and Kruskal-Wallis test (PAEDS and CHEOPS). The Spearman correlation coefficient was used to confirm the correlation between the two scales.
      Results: Although desflurane resulted in the fastest extubation, other scales were not statistically different. PAEDS and CHEOPS for sevoflurane showed a positive correlation in the early recovery period, but desflurane and propofol did not.
      Conclusions: With the same depth of anesthesia, emergence agitation among desflurane, sevoflurane, and propofol was not different in children.

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      다국어 초록 (Multilingual Abstract)

      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indicates emergence agitation with propofol is also frequent. We tested the hypothesis that depth of anesthesia could lead to frequent emergence agitation with propofol.
      Methods: Sixty children, ASA 1, aged 3−12 years, undergoing general anesthesia for adenotonsillectomy were randomized to receive maintenance anesthesia with sevoflurane, desflurane, or propofol. The bispectral index was monitored and maintained within 40−65. Time to extubation, duration of postanesthetic care units stay, bispectral index just before stopping the anesthetic agent, anesthetic time, early and late postoperative Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) were compared among the 3 groups. Data were analyzed using ANOVA (demographic data, measured time interval, BIS) and Kruskal-Wallis test (PAEDS and CHEOPS). The Spearman correlation coefficient was used to confirm the correlation between the two scales.
      Results: Although desflurane resulted in the fastest extubation, other scales were not statistically different. PAEDS and CHEOPS for sevoflurane showed a positive correlation in the early recovery period, but desflurane and propofol did not.
      Conclusions: With the same depth of anesthesia, emergence agitation among desflurane, sevoflurane, and propofol was not different in children.
      번역하기

      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indi...

      Background: Sevoflurane, desflurane, and propofol are widely used in pediatric anesthesia because of their rapid recovery. However, emergence agitation is more reported with sevoflurane or desflurane than with propofol. Our clinical experience indicates emergence agitation with propofol is also frequent. We tested the hypothesis that depth of anesthesia could lead to frequent emergence agitation with propofol.
      Methods: Sixty children, ASA 1, aged 3−12 years, undergoing general anesthesia for adenotonsillectomy were randomized to receive maintenance anesthesia with sevoflurane, desflurane, or propofol. The bispectral index was monitored and maintained within 40−65. Time to extubation, duration of postanesthetic care units stay, bispectral index just before stopping the anesthetic agent, anesthetic time, early and late postoperative Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) were compared among the 3 groups. Data were analyzed using ANOVA (demographic data, measured time interval, BIS) and Kruskal-Wallis test (PAEDS and CHEOPS). The Spearman correlation coefficient was used to confirm the correlation between the two scales.
      Results: Although desflurane resulted in the fastest extubation, other scales were not statistically different. PAEDS and CHEOPS for sevoflurane showed a positive correlation in the early recovery period, but desflurane and propofol did not.
      Conclusions: With the same depth of anesthesia, emergence agitation among desflurane, sevoflurane, and propofol was not different in children.

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      참고문헌 (Reference)

      1 Grundmann U, "Total intravenous anaesthesia with propofol and remifentanil in paediatric patients: a comparison with a desflurane-nitrous oxide inhalation anaesthesia" 42 : 845-850, 1998

      2 Cravero JP, "The effect of small dose fentanyl on the emergence characteristics of pediatric patients after sevoflurane anesthesia without surgery" 97 : 364-367, 2003

      3 McGrath PJ, "Schillinger J, Dunn J, Chapman J: CHEOPS: a behavioral scale for rating postoperative pain in children. In: Advances in Pain Research and Therapy 9" 395-402, 1985

      4 Davis PJ, "Recovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringotomy and pressure equalization tube insertion" 88 : 34-38, 1999

      5 Davis PJ, "Recovery characteristics of desflurane versus halothane for maintenance of anesthesia in pediatric ambulatory patients" 80 : 298-302, 1994

      6 Cohen IT, "Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol" 13 : 63-67, 2003

      7 Picard V, "Quality of recovery in children: sevoflurane versus propofol" 44 : 307-310, 2000

      8 Nakayama S, "Propofol reduces the incidence of emergence agitation in preschool-aged children as well as in school-aged children: a comparison with sevoflurane" 21 : 19-23, 2007

      9 Cohen IT, "Propofol or midazolam do not reduce the incidence of emergence agitation associated with desflurane anaesthesia in children undergoing adenotonsillectomy" 12 : 604-609, 2002

      10 Dalens BJ, "Prevention of emergence agitation after sevoflurane anesthesia for pediatric cerebral magnetic resonance imaging by small doses of ketamine or nalbuphine administered just before discontinuing anesthesia" 102 : 1056-1061, 2006

      1 Grundmann U, "Total intravenous anaesthesia with propofol and remifentanil in paediatric patients: a comparison with a desflurane-nitrous oxide inhalation anaesthesia" 42 : 845-850, 1998

      2 Cravero JP, "The effect of small dose fentanyl on the emergence characteristics of pediatric patients after sevoflurane anesthesia without surgery" 97 : 364-367, 2003

      3 McGrath PJ, "Schillinger J, Dunn J, Chapman J: CHEOPS: a behavioral scale for rating postoperative pain in children. In: Advances in Pain Research and Therapy 9" 395-402, 1985

      4 Davis PJ, "Recovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringotomy and pressure equalization tube insertion" 88 : 34-38, 1999

      5 Davis PJ, "Recovery characteristics of desflurane versus halothane for maintenance of anesthesia in pediatric ambulatory patients" 80 : 298-302, 1994

      6 Cohen IT, "Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol" 13 : 63-67, 2003

      7 Picard V, "Quality of recovery in children: sevoflurane versus propofol" 44 : 307-310, 2000

      8 Nakayama S, "Propofol reduces the incidence of emergence agitation in preschool-aged children as well as in school-aged children: a comparison with sevoflurane" 21 : 19-23, 2007

      9 Cohen IT, "Propofol or midazolam do not reduce the incidence of emergence agitation associated with desflurane anaesthesia in children undergoing adenotonsillectomy" 12 : 604-609, 2002

      10 Dalens BJ, "Prevention of emergence agitation after sevoflurane anesthesia for pediatric cerebral magnetic resonance imaging by small doses of ketamine or nalbuphine administered just before discontinuing anesthesia" 102 : 1056-1061, 2006

      11 Henneberg SW, "Peroperative depth of anaesthesia may influence postoperative opioid requirements" 49 : 293-296, 2005

      12 Denman WT, "Pediatric evaluation of the bispectral index (BIS) monitor and correlation of BIS with end-tidal sevoflurane concentration in infants and children" 90 : 872-877, 2000

      13 Murat I, "Is there a place for desflurane in paediatric anaesthesia?" 12 : 663-664, 2002

      14 Lerman J, "Inhalational anesthetics" 14 : 380-389, 2004

      15 Cole JW, "Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia" 12 : 442-447, 2002

      16 Uezono S, "Emergence agitation after sevoflurane versus propofol in pediatric patients" 91 : 563-566, 2000

      17 Demirbilek S, "Effects of fentanyl on the incidence of emergence agitation in children receiving desflurane or sevoflurane anaesthesia" 21 : 538-542, 2004

      18 Shukry M, "Does dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia?" 15 : 1098-1104, 2005

      19 Sikich N, "Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale" 100 : 1138-1145, 2004

      20 Welborn LG, "Comparison of emergence and recovery characteristics of sevoflurane, desflurane, and halothane in pediatric ambulatory patients" 83 : 917-920, 1996

      21 Powers KS, "Bispectral index as a guide for titration of propofol during procedural sedation among children" 115 : 1666-1674, 2005

      22 Sigl JC, "An introduction to bispectral analysis for the electroencephalogram" 10 : 392-404, 1994

      23 Voepel-Lewis T, "A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit" 96 : 1625-1630, 2003

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