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PO-0933 Pharmacological Treatment Of Emergence Agitation Related To Sevoflurane Anaesthesia
  1. M Feltrin1,
  2. AF Centroni2,
  3. J Ropero Pelaez3,
  4. F Monteiro1,
  5. S Arenas1,
  6. I Silva1,
  7. M Ribeiro1,
  8. S Taniguchi1
  1. 1Basic Sciences, Albert Einstein Hospital, São Paulo, Brazil
  2. 2Oncology, Albert Einstein Hospital, São Paulo, Brazil
  3. 3Center of Mathematics Computation and Cognition, Universidade Federal Do ABC, Santo Andre, Brazil

Abstract

Sevoflurane anaesthesia is often related to emergence agitation. This study investigates the drugs administered to treat this side effect.

Methods Our retrospective study included 100 oncologic paediatric patients with mean age of 33.67 ± 2.12 months, weight mean 15.22 ± 0.44 kg, height 94.68 ± 2.24 cm undergoing anaesthesia for radiotherapy immobilisation purpose.

Results Sevoflurane 8% was administered to 100% of the patients for anaesthesia induction/maintenance. The number of radiotherapy session were 22.43 ± 1.01 days and the period of anaesthesia was 33.09 ± 1.81 min.

Emergence agitation was observed during anaesthesia recovery in 73% patients and was treated with propofol 0.5–4.4 mg/kg (29 patients), midazolam 0.35–79 mg/kg (12 patients), nalbuphine 0.1–0.15 mg/kg (4 patients), haloperidol 1,5 mg/kg (4 patients) and fentanyl 2–3.6 mg/kg (1 patient).

All these central depressant drugs controlled the emergence agitation except haloperidol which induced extrapyramidal side effect (akathisia).

Conclusions Respiratory depression should be considered in sevoflurane association with central nervous system depressants.

Although midazolam has flumazenil as antagonist, midazolam high dosages should be administered with caution. Neuroleptics, such as haloperidol, is not an appropriated choice for agitation considering the possibility of akathisia.

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