RISK FACTORS FOR POST OPERATIVE COGNITIVE DYSFUNCTION

POSTOPERATIVE AGITATION / EMERGENCE DELIRIUM IN CHILDREN AFTER SEVOFLURANE ANAESTHESIA

 

✔️Incidence up to more than 40%

✔️Might be occurring together with EEG-changes 

✔️Methods usually tried to reduce the incidence:  addition of nitrous oxide, premedication with benzodiazepines, early extubation, switching to other inhaled anaesthetics

✔️Propofol maintenance after sevoflurane induction seems to be the best alternative.

✔️A recent study also indicates that a switch to desflurane for maintenance after sevoflurane inhalation induction reduces the incidence of emergence agitation by 50 % 

✔️ A paranoid delusion is said to be a common feature of this state of agitation. 

✔️ Information about this phenomenon should be explained to the parents before the procedure. 

#EmergenceDelirium , #Sevoflurane , #PostoperativeAgitation , #anaesthesia ,#Propofol

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Reference:

MayerJ,BoldtJ,Röhm K Detal (2006) Desflurane  after Sevoflurane  inhaled  induction reduces severity of emergence agitation in children undergoing minor ear nose-throat surgery compared with sevoflurane induction and maintenance. Anesth Analg 102:400-404 22. 

Breschan C, Platzer M, Jost R et al (2007) Midazolam does not reduce emergence delirium after sevoflurane anesthesia in children. Pediatr Anesth 17:347-352

UezonoS,GotoT,TeruiKetal(2000)Emergence agitation after sevoflurane  versus propofol in pediatric patients. Anesth Analg 91:563-566 20. 

NakayamaS,FurukawaH,YanaiH(2007)propofol reduces incidence of emergence agitation in preschool-aged children as well as in school-aged children: a comparison with sevoflurane. J Anesth 21:19-23

Moos DD (2005) Sevo and emergence behavioural changes in pediatrics .JPeri Anesth Nurs 20:13-18