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KMID : 0878619990030020087
Korean Journal of Pediatric Anesthesia
1999 Volume.3 No. 2 p.87 ~ p.92
The Effects of Anesthetic Methods on Emergence Delirium in Children
Chung Chan-Jong

Lee Seung-Cheol
Lee Hwang-Jae
Lee Soo-Il
Abstract
Background: Children may exhibit agitated behavior on emergence from general anesthesia. The aim of this study was to assess the effects of anesthetic methods on emergence delirium in children.

Methods: One hundred eighty children, ASA physical status I or II, aged 1¡­10 yr, scheduled for minor surgery, were randomly assigned to one of six groups (n=30 in each); ketamine-enflurane, ketamine-isoflurane, ketamine-propofol, midazolam-enflurane, midazolam-isoflurane, and midazolam-propofol. Anesthesia was induced by either ketamine 2 §·/§¸ or midazolam 0.2 §·/§¸ and maintained with either enflurane, isoflurane, or propofol under 66% N2O. For postoperative analgesia, ketorolac 1 §·/§¸ was administered intravenously 5 min before the end of surgery. The status of emergence delirium (ED) was evaluated by a blinded observer until discharge from postanesthetic care unit.

Results: There was no difference in age, NPO time, status of preanesthetic anxiety, type of surgery, anesthetic time and recovery time among the six groups. ED occurred in 53 children (29.4%) and persisted for 5¡­25 min. Either midazolam or fentanyl as treatment of severe ED was received in 17 children (9.4%). The incidence of ED was not different among the six groups. Compared with the ketamine-propofol group, the midazolam-propofol group showed less incidence, less severity and shorter duration in ED. Compared with the nonED group, the ED group had younger age, more
temperament, shorter anesthetic time, shorter time to emergence.

Conclusions: Child¡¯s age, underlying temperament, anesthetic agent, and length of procedure appear to influence ED in children.
KEYWORD
Anesthesia: pediatric, Anesthetics, intravenous: ketamine, midazolam, propofol, Anesthetics, volatile: enflurane, isoflurane, Complication: emergence delirium
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