Title: Effect of Midazolam and Propofol in Prevention of Emergence Agitation in Paediatric Patients Under Sevoflurane Based Anaesthesia: A Comparative Study

Authors: Subrata Mandal, Moumita Ghosh Nandi, Gaurav Majumdar, Shantanu Ghosh

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.150

Abstract

Introduction: Sevoflurane is the most commonly used inhalational anaesthetic agent in paediatric setup. The incidence of emergence agitation (EA) is high in children after sevoflurane anaesthesia. The efficacy of propofol and midazolam in preventing EA remains debatable. This study was conducted to compare the effects of administration of a single dose of propofol or midazolam on sevoflurane-based general anaesthesia on EA during the recovery period.

Methods: One hundred and thirty two children, ASA I-II, aged 2 to 10 years undergoing abdominal and urogenital surgeries were enrolled in this prospective,double blind study. Children were randomly allocated to receive propofol 1 mg/kg (group P, n=66) or midazolam 0.1 mg/kg (group M, n=66) 5 minutes before the end of surgery. Aonosfour point scale and Paediatric Anaesthesia Emergence Delirium (PAED) scale were used to evaluate the incidence and severity of EA, respectively.

Results: The incidence of EA in group M was 43.9% (29/66) and 83.3% (55/66) in group P. PAED scores were significantly lower in group M. Duration of PACU stay was delayed in group P than in group M.

Conclusion: Administration of midazolam (0.1 mg/kg ) prevents incidence and severity of EA more effectively than propofol (1 mg/kg )in paediatric patients receiving sevoflurane based general anaesthesia.

Keywords: children, emergence agitation, midazolam, propofol, sevoflurane.

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Corresponding Author

Dr Subrata Kumar Mandal

Associate Professor, Dept. of Anaesthesiology and Critical Care

North Bengal Medical College and Hospital, Siliguri-734012, India

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