Emergence agitation in children after propofol versus halothane anesthesia

Background: The administration of anesthetic agents is associated with a high incidence of emergence agitation in children. Halothane and propofol appear to cause much less emergence agitation. The aim of this study was to compare the incidence of emergence agitation in children receiving either propofol or halothane anesthesia for a variety of surgical treatments using the Pediatric Anesthesia Emergence Delirium (PAED) scale.
Material and Method: The subjects were 83 premedicated children aged 1 to 6 years who underwent surgical procedures with propofol (group P, n=41) or with halothane (group H, n=42) anesthesia. The mean dose during maintenance of anesthesia with propofol was 9.0 mg/kg/h or halothane 1.5-2% and fentanyl at a total dose of 5 microg/kg administered during surgery. Recovery time, preoperative anxiety, postoperative pain, and emergence agitation were noted. Adverse effects during and after operation were also recorded.
Results: Group P had a significantly higher proportion of patients who exhibited emergence agitation than group H (29.3% vs. 9.5%, respectively, P<0.05). The PAED scale score in group H was 4 (range: 0-16) and in group P 8 (range: 2-20). The mean recovery time in group P was significantly shorter than in group H (16.1+/-4.3 vs. 20.5+/-5.4 minutes, respectively, P<0.01).
Conclusions: In children, the administration of propofol maintenance anesthesia is associated with a significantly higher incidence of emergence agitation than halothane maintenance anesthesia.

Keywords: Propofol - adverse effects, Halothane - adverse effects, Demography, Child, Delirium - etiology, Anesthetics, Intravenous - adverse effects, Anesthetics, Inhalation - adverse effects, Anesthesia Recovery Period, Anesthesia, Psychomotor Agitation - etiology