Effect of prophylactic use of propofol on emergence agitation following sevoflurane anesthesia in pediatric patients: a meta-analysis / 中华麻醉学杂志

ABSTRACT

Objective:To systematically review the effect of prophylactic use of propofol on emergence agitation (EA) following sevoflurane anesthesia in pediatric patients.Methods:Databases such as Pubmed, Web of Scince, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, Wanfang Data and VIP were searched for randomized controlled trials involving the comparison of effects of propofol (1 mg/kg) versus normal saline on EA following sevoflurane anesthesia in pediatric patients using computers from inception to December 1, 2020.Evaluation indexes included incidence of agitation, Pediatric Anesthesia Emergence Delirium (PAED) scale, awakening time, postanesthesia care unit (PACU) stay time and incidence of adverse events.The Cochrane Collaboration′s tool for assessing risk of bias was used to evaluate the quality of the included trials.The meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results:Sixteen randomized controlled clinical trials involving 1 061 patients were included in this meta-analysis.The patients were divided into 2 groups propofol group ( n=531) and normal saline group ( n=530). Compared with group normal saline, incidence of EA and PAED score were significantly decreased in group propofol ( P<0.05), and there was no significant difference in the incidence of postoperative nausea and vomiting, incidence of other adverse events and PACU stay time between the 2 groups ( P>0.05). Conclusion:Prophylactic dose of propofol (1 mg/kg) for sevoflurane-based anesthesia can reduce the degree of EA and decrease its incidence without increasing the occurrence of adverse reactions in pediatric patients.