PREVENTION OF SEVOFLURANE RELATED EMERGENCE AGITATION IN CHILDREN UNDERGOING COCHLEAR IMPLANT: A COMPARISON OF NALBUPHINE AND PROPOFOL

*Dr. Sameer Goyal, Dr. Prakash Chandra Audichya, Dr. Komal Soni, Dr. Jyoti Petkar, Dr. R.K. Singh

ABSTRACT

Background: Aim of present study was to compare the effect of single dose of propofol or nalbuphine prior to termination of sevoflurane based anesthesia on incidence and severity of EA in children. Methods: Thirty children, ASA I-II, 18 months to 8 years old undergoing cochlear implant surgery under sevoflurane based anesthesia were enrolled in the study. Children were randomly allocated to one of three equal groups: Group C received 10 ml saline 0.9%, Group P received propofol 1 mg/kg and group N received nalbuphine 0.1 mg/kg-1. Study drugs were administered 5 min before the end of surgery. In post anesthesia care unit (PACU), incidence of EA was assessed with Aonos four point scale and severity of EA was assessed with pediatric anesthesia emergence delirium scale upon admission (T0), after 5 min (T5), 15 min (T15) and 30 min (T30). Extubation time, emergence time and duration of PACU stay were assessed. Results: Incidence and severity of EA were lower in group P and group N compared to group C at T0, T5 and T15 . Incidence and severity of EA in group P were higher than group N at same times. Incidence and severity of EA decreased significantly over time in all groups. The modified Children's Hospital of Eastern Ontario Pain Scale was lower in group N compared to group P and group C. Conclusions: Although statistically not significant but Nalbuphine 0.1mg/kg1 was more effective than propofol 1 mg/kg in decreasing incidence and severity of EA, when administered 5 min before end of surgery in children undergoing cochlear implant surgery under sevoflurane anesthesia.

Keywords: Children, nalbuphine, emergence agitation, propofol, sevoflurane.