Abstract PR281

ANAESTHESIA Background & Objectives: The occurrence of emergence delirium (ED) in children after sevoflurane-based anaesthesia is common; ranging from 10% to 80%. Although it is a self limiting phenomenon, it leads to an unpleasant experience to the children and a stressful event to their parents. This prospective, randomised, double blind study was carried out to compare the effectiveness of intravenous (IV) propofol 0.5 mg/kg or 1.0 mg/kg at the end of surgery when compared to placebo (normal saline) in reducing the incidence of ED in children after sevoflurane-based anaesthesia. Materials & Methods: A total of 120 ASA I or II children aged 3-12 years undergoing day care surgery were recruited into the study. These children were randomised into three groups: Group 1 (propofol 0.5 mg/kg, n=43), Group 2 (propofol 1.0 mg/kg, n=40) or Group 3 (normal saline, n=37). Anaesthesia was induced with sevoflurane in oxygen/air mixture (1:1) and maintained with minimum alveolar concentration (MAC) of 1.0-1.2 of sevoflurane via a laryngeal mask airway (LMA). At the end of surgery, sevoflurane administration discontinued and IV propofol or saline were given to the children based on their group allocation. Time to the removal of LMA and the emergence time were both recorded. The incidence of ED was assessed using the Paediatric Anaesthesia Emergence Delirium (PAED) scale in post anaesthetic care unit (PACU). Results: The overall incidence of ED in recovery was 38.3%. The incidence of ED in the three groups were 30.0% in Group 1, 27.5% in Group 2 and 59.5% in Group 3 (p value = 0.006) respectively. The incidence of ED were significantly reduced in Group 1 (p value = 0.005) as well as in Group 2 (p value = 0.009) compared to Group 3. The administration of propofol at the end of surgery reduced the overall incidence of ED by 29.3% in Group 1 and 32.0% in Group 2 when compared to normal saline (Group 3). There was no difference in term of time of LMA removal and emergence time among the three groups. Conclusion: The administration of IV propofol 0.5 mg/kg or 1.0 mg/kg reduced the overall incidence of ED in children after sevoflurane-based anaesthesia when compared to normal saline. There was no significant difference between the two dosages of propofol in reducing the incidence of ED and both dosages had similar safety profiles. References: 1. Wells L.T., Rasch D.K. Emergence “delirium” after sevoflurane anaesthesia: a paranoid delusion? Anesth Analg 1999; 88: 1308-1310. 2. Sikich N., Lerman J. Development and psychometric evaluation of the Paediatric Aneasthesia Emergence Delirium Scale. Anesthesiology. 2004; 100: 1138-1145. Disclosure of Interest: None declared