Bolus Doses of Ketofol versus Dexmedetomidine for the Prevention of Emergence Agitation in Children: A Prospective Randomized Controlled Clinical Trial
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 5
Abstract
Background: Emergency agitation in children is a common problem with sevoflurane anesthesia which includes phenomena such as crying, excitation, agitation, delirium, and behavioral disturbances during early emergence from general anesthesia. Materials and Methods: After the institutional ethics committee approval and written informed consent, 75 children aged 3-10 years, belonging to ASA I and II posted for oropharyngeal and urological surgeries, were randomly allocated for this randomized controlled study. Children were randomly assigned into three groups of 25 each into NS (control), KF (ketofol, k-0.25 mg/kg, p-1 mg/kg), and D (dexmedetomidine 0.3 ug/kg) groups. All the study drugs were administered 10 min before the end of surgery in the respective groups. In the post-anesthetic care unit (PACU), all children were evaluated for emergence agitation with modified objective pain scale (MOPS) and pediatric anesthesia emergency delirium scale (PAED) scores at 0, 10, 20, and 30 min, respectively. Hemodynamics and other side effects were monitored in the PACU. When all the children satisfied discharge criteria, they were shifted to the ward. Results: The incidence and severity of emergence delirium were significantly high in the control group when compared to ketofol and dexmedetomidine groups according to MOPS and PAED scores at 0, 10, 20, and 30 min time intervals at PACU. Emergence agitation reduction was comparable between ketofol and dexmedetomidine groups, the difference being that in dexmedetomidine group, all the children satisfied discharge criteria earlier than ketofol group, and they appeared to be calm and cooperative while children of ketofol group were mildly restless. However, the difference between KF and D groups was not statistically significant. Conclusion: Dexmedetomidine and ketofol caused a significant reduction in the incidence and severity of emergence agitation when compared to control group. Ketofol was as effective as dexmedetomidine in the prevention of emergence agitation when administered before the end of surgery, but children administered dexmedetomidine were calm and satisfied discharge criteria earlier than ketofol.
Authors and Affiliations
Krishna Prasad, Paleti Sophia, B Sowbhagya Lakshmi
Keywords
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