A Comparison of The Effects of Desflurane and Sevoflurane In Pediatric Adenotonsillectomy Operations
Abstract
Objectives: Adenoidectomy and adenotonsillectomy operations are ambulatory Outpatient surgeries that are common in pediatric patients. The anesthetics agents which have low blood-tissue-lipid solubility is a good choice for the ambulatory surgery due to rapid induction and emergence. The purpose of this study was to compare the hemodynamic effects and the quality of recovery from desflurane and sevoflurane anesthesia in pediatric patients. Patients and Methods: Fifty-two ASA physical status I patients, aged between 3-10 that underwent adenoidectomy and adenotonsillectomy were studied. Patients were randomly assigned into two groups: Group D and Group S. After the standard anesthesia induction, 4% desflurane in Group D and 2% sevoflurane in Group S were administered with 40% oxygen – 60% nitrous oxide for maintenance of anesthesia. Heart rate, Mean arterial pressure and oxygen saturation were recorded before induction, after induction, at intubation, 1., 5., 15., 30. minutes and at the end of the operation and after the extubation. Operation time, anesthesia time and the extubation time were recorded. Patients have stayed in the post-anesthesia care unit for 20 minutes. Modified Aldrete score and the pain-discomfort scale were used to evaluate the quality of emergence from anesthesia. Results: The demographic data and hemodynamic parameters were similar between the two groups. Extubation time was shorter in the desflurane group p
Keywords
References
- Patel A, Davidson M, Tran MC, Quraishi H, Schoenberg C, Sant M, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg 2010;111:1004–10. [CrossRef]
- Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C, et al. Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: a meta-analysis of published studies. Br J Anaesth 2010;104:216–23. [CrossRef]
- Edler AA, Mariano ER, Golianu B, Kuan C, Pentcheva K. An analysis of factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Analg 2007;104:784–9. [CrossRef]
- Cohen IT, Hannallah RS, Hummer KA. The incidence of emergence agitation associated with desflurane anesthesia in children is reduced by fentanyl. Anesth Analg 2001;93:88–91. [CrossRef]
- Lee YS, Kim WY, Choi JH, Son JH, Kim JH, Park YC. The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia. Korean J Anesthesiol 2010;58:440–5. [CrossRef]
- Park JH, Lim BG, Kim HZ, Kong MH, Lim SH, Kim NS, Lee IO. Comparison of emergence agitation between sevoflurane/ nitrous oxide administration and sevoflurane administration alone in children undergoing adenotonsillectomy with preemptive ketorolac. Korean J Anesthesiol 2014;66:34–8. [CrossRef]
- Kim HS, Byon HJ, Kim JE, Park YH, Lee JH, Kim JT. Appropriate dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for tonsillectomy or adenoidectomy in children: up and down sequential allocation. BMC Anesthesiol 2015;15:79. [CrossRef]
- Sury MRJ, Black A, Hemington L, Howard R, Hatch DJ, Mackersie A. A comparison of recovery characteristics of sevoflurane and halothane in children. Anaesthesia 1996;51:543–6. [CrossRef]
- Cohen IT, Finkel JC, Hannallah RS, Hummer KA, Patel KM. The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children. Anesth Analg 2002;94:1178–81. [CrossRef]
- Cohen IT, Drewsen S, Hannallah RS. Propofol or midazolam do not reduce the incidence of emergence agitation associated with desflurane anaesthesia in children undergoing adenotonsillectomy. Paediatr Anaesth 2002;12:604–9. [CrossRef]
- Viitanen H, Annila P, Viitanen M, Tarkkila P. Premedication with midazolam delays recovery after ambulatory sevoflurane anesthesia in children. Anesth Analg 1999;89:75–9. [CrossRef]
- Shorten GD, Crawford MW, Louis P. The neuromuscular effects of mivacurium chloride during propofol anesthesia in children. Anesth Analg 1996;82:1170–5. [CrossRef]
- Watcha MF, Safavi FZ, McCulloch DA, Tan TSH, White PF. Effect of antagonism of mivacurium-induced neuromuscular block on postoperative emesis in children. Anesth Analg 1995;80:713–17. [CrossRef]
- Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology 1992;77:162– 84. [CrossRef]
- Pandit UA, Malviya S, Lewis IH. Vomiting after outpatient tonsillectomy and adenoidectomy in children: The role of nitrous oxide. Anesth Analg 1995;80:230–3. [CrossRef]
- Uezono S, Goto T, Terui K, Ichinose F, Ishguro, Nakata Y, Morita S. Emergence agitation after sevoflurane versus propofol in pediatric patients. Anesth Analg 2000;91:563–6. [CrossRef]
- Aono J, Ueda W, Mamiya K, Takimoto E, Manabe M. Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys. Anesthesiology 1997;87:1298–300. [CrossRef]
- Lapin SL, Auden SM, Goldsmith LJ, Reynolds AM. Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane. Paediatr Anaesth 1999;9:299–304. [CrossRef]
- Costi D, Ellwood J, Wallace A, Ahmed S, Waring L, Cyna A. Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial. Paediatr Anaesth 2015;25:517–23. [CrossRef]
- Picard V, Dumont L, Pellegrini M. Quality of recovery in children: sevoflurane versus propofol. Acta Anaesthesiol Scand 2000;44:307– 10. [CrossRef]
- Sarner J B, Levine M, Davis PJ, Lerman J, Cook DR, Motoyama EK. Clinical characteristics of sevoflurane in children. Anesthesiology 1995;82:38–46. [CrossRef]
- Welborn LG, Hannallah RS, Norden JM, Ruttimann UE, Callan CM. Comparison of emergence and recovery characteristics of sevoflurane, desflurane, and halothane in pediatric ambulatory patients. Anesth Analg 1996;83:917–20. [CrossRef]
Pediatrik Adenotonsillektomi Operasyonlarında Desfluran ile Sevofluran Etkilerinin Karşılaştırılması
Abstract
Amaç: Adenoidektomi ve adenotonsillektomi operasyonları çocukluk çağında sıklıkla yapılan günübirlik cerrahi işlemlerdendir. Kan,doku ve yağda düşük çözünürlüğe sahip inhalasyon anestezikleri, hızlı indüksiyon ve derlenme sağlaması ile günübirlik cerrahi için iyi bir seçenektir.Bu çalışmamızda desfluran ve sevofluran inhalasyon anestezik ilaçlarının çocuk olgularda hemodinamik etkileri ve derlenme kalitelerinin karşılaştırılması amaçlanmıştır. Hastalar ve Yöntemler: Adenoidektomi ve adenotonsillektomi operasyonu uygulanacak ASA I grubuna dahil, 3-10 yaşlarında, 52 olgu çalışmaya alındı. Tüm olgular rastgele iki gruba ayrıldı: Grup D ve Grup S. Standard anestezi indüksiyonu uygulandıktan sonra anestezi idamesi için %40 Oksijen O2 - %60 Azot protoksit N2O ile birlikte Grup D’de %4 desfluran uygulanırken Grup S’de %2 sevofluran uygulandı. İndüksiyon zamanı, entübasyon zamanı, operasyonun 1., 5., 15. ve 30. dakikalarında, cerrahi bitiş ve ekstübasyon zamanında kalp atım hızı KAH , ortalma arteryel basınç OAB ve periferik oksijen satürasyon SpO2 değerleri kaydedildi. Olguların cerrahi, anestezi ve ekstübasyon süreleri kaydedildi. Olgular Derlenme Ünitesinde 20 dakika gözlendi. Modifiye Aldrete skalası ve Ağrı-konfor skalası ile anesteziden derlenmenin kalitesi değerlendirildi. Bulgular: Her iki grupta demografik özellikler ve hemodinamik etkiler benzer bulundu. Ekstübasyon zamanı Grup D’de daha kısa bulundu p
Keywords
References
- Patel A, Davidson M, Tran MC, Quraishi H, Schoenberg C, Sant M, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg 2010;111:1004–10. [CrossRef]
- Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C, et al. Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: a meta-analysis of published studies. Br J Anaesth 2010;104:216–23. [CrossRef]
- Edler AA, Mariano ER, Golianu B, Kuan C, Pentcheva K. An analysis of factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Analg 2007;104:784–9. [CrossRef]
- Cohen IT, Hannallah RS, Hummer KA. The incidence of emergence agitation associated with desflurane anesthesia in children is reduced by fentanyl. Anesth Analg 2001;93:88–91. [CrossRef]
- Lee YS, Kim WY, Choi JH, Son JH, Kim JH, Park YC. The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia. Korean J Anesthesiol 2010;58:440–5. [CrossRef]
- Park JH, Lim BG, Kim HZ, Kong MH, Lim SH, Kim NS, Lee IO. Comparison of emergence agitation between sevoflurane/ nitrous oxide administration and sevoflurane administration alone in children undergoing adenotonsillectomy with preemptive ketorolac. Korean J Anesthesiol 2014;66:34–8. [CrossRef]
- Kim HS, Byon HJ, Kim JE, Park YH, Lee JH, Kim JT. Appropriate dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for tonsillectomy or adenoidectomy in children: up and down sequential allocation. BMC Anesthesiol 2015;15:79. [CrossRef]
- Sury MRJ, Black A, Hemington L, Howard R, Hatch DJ, Mackersie A. A comparison of recovery characteristics of sevoflurane and halothane in children. Anaesthesia 1996;51:543–6. [CrossRef]
- Cohen IT, Finkel JC, Hannallah RS, Hummer KA, Patel KM. The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children. Anesth Analg 2002;94:1178–81. [CrossRef]
- Cohen IT, Drewsen S, Hannallah RS. Propofol or midazolam do not reduce the incidence of emergence agitation associated with desflurane anaesthesia in children undergoing adenotonsillectomy. Paediatr Anaesth 2002;12:604–9. [CrossRef]
- Viitanen H, Annila P, Viitanen M, Tarkkila P. Premedication with midazolam delays recovery after ambulatory sevoflurane anesthesia in children. Anesth Analg 1999;89:75–9. [CrossRef]
- Shorten GD, Crawford MW, Louis P. The neuromuscular effects of mivacurium chloride during propofol anesthesia in children. Anesth Analg 1996;82:1170–5. [CrossRef]
- Watcha MF, Safavi FZ, McCulloch DA, Tan TSH, White PF. Effect of antagonism of mivacurium-induced neuromuscular block on postoperative emesis in children. Anesth Analg 1995;80:713–17. [CrossRef]
- Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology 1992;77:162– 84. [CrossRef]
- Pandit UA, Malviya S, Lewis IH. Vomiting after outpatient tonsillectomy and adenoidectomy in children: The role of nitrous oxide. Anesth Analg 1995;80:230–3. [CrossRef]
- Uezono S, Goto T, Terui K, Ichinose F, Ishguro, Nakata Y, Morita S. Emergence agitation after sevoflurane versus propofol in pediatric patients. Anesth Analg 2000;91:563–6. [CrossRef]
- Aono J, Ueda W, Mamiya K, Takimoto E, Manabe M. Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys. Anesthesiology 1997;87:1298–300. [CrossRef]
- Lapin SL, Auden SM, Goldsmith LJ, Reynolds AM. Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane. Paediatr Anaesth 1999;9:299–304. [CrossRef]
- Costi D, Ellwood J, Wallace A, Ahmed S, Waring L, Cyna A. Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial. Paediatr Anaesth 2015;25:517–23. [CrossRef]
- Picard V, Dumont L, Pellegrini M. Quality of recovery in children: sevoflurane versus propofol. Acta Anaesthesiol Scand 2000;44:307– 10. [CrossRef]
- Sarner J B, Levine M, Davis PJ, Lerman J, Cook DR, Motoyama EK. Clinical characteristics of sevoflurane in children. Anesthesiology 1995;82:38–46. [CrossRef]
- Welborn LG, Hannallah RS, Norden JM, Ruttimann UE, Callan CM. Comparison of emergence and recovery characteristics of sevoflurane, desflurane, and halothane in pediatric ambulatory patients. Anesth Analg 1996;83:917–20. [CrossRef]
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 1, 2019 |
| Published in Issue | Year 2019Issue: 4 |