Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

School of Nursing

Department

Nursing

Date of Original Version

2016

Abstract

Emergence agitation (EA) is common among pediatric patients undergoing general anesthesia. Sevoflurane is a volatile anesthetic that is associated with an increased incidence of EA of as high as 80% in children undergoing surgery. Emergence agitation can cause increased stress in the patient, nurses and caregivers. Agitation experienced by the patient can also increase the risk of self harm, delay medical treatments, damage equipment and ultimately increase the length of stay in the hospital. Current studies lack a consistent method of quantifying and recognizing EA in a standardized manner. The development of the Pediatric Anesthesia Emergence Delirium (PAED) scale provided a reliable and accurate tool to assess EA in pediatric patients. Propofol has been used in sub-hypnotic doses to reduce both the incidence and severity of EA. The purpose of this systematic review was to examine the current literature to determine if there is an effect on PAED scores of patients that undergo general anesthesia with sevoflurane after receiving an intravenous dose of propofol prior to emergence. This systematic review was created using guidelines put forth by both PRISMA and CONSORT. A literature review was performed and data were collected from each study. A cross study analysis was performed using data collection tables created by the author of this systematic review. Propofol was found to decrease both the incidence and severity of EA in pediatric patients undergoing ophthalmic, inguinal hernia repair, adenostonsillectomies and non-painful procedures such as MRI scans. By incorporating the use of propofol in the anesthetic plan for pediatric patients, anesthesia providers will be able to decrease the incidence the EA and its’ associated adverse outcomes.

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