Document Detail

The effect of sub-Tenon lidocaine injection on emergence agitation after general anaesthesia in paediatric strabismus surgery.
MedLine Citation:
PMID:  21206277     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Sevoflurane is widely used for paediatric anaesthesia. However, many cases of emergence agitation after sevoflurane anaesthesia have been reported and pain was suggested as a major contributing factor. The purpose of this study was to evaluate the effect of sub-Tenon lidocaine injection on emergence agitation in children receiving sevoflurane or propofol-remifentanil anaesthesia.
METHODS: We enrolled 260 children, aged 4-10 years, who were scheduled for strabismus surgery, and randomized them to one of four groups: group SS, SL, BS, and BL. Anaesthesia was maintained with sevoflurane (SS, SL) or propofol-remifentanil infusion (BS, BL). At the end of surgery, the surgeon injected into the sub-Tenon space 1 ml of isotonic saline (SS, BS) or 2% lidocaine (SL, BL). Emergence behaviour was assessed in the post-anaesthesia care unit using a 5-point scoring scale (score 1, asleep; 2, awake and calm; 3, irritable or consolable crying; 4, inconsolable crying; and 5, severe restlessness). We defined a score of 4 or 5 as emergence agitation. The incidence of emergence agitation was analysed using χ² and Fisher's exact test.
RESULTS: The incidence of emergence agitation in group SL and BL was significantly lower compared to group SS and BS, respectively (P = 0.011, 0.019). The lidocaine-injected group showed significantly lower occurrence of emergence agitation (10.4%) than isotonic saline-injected group (27.2%; P = 0.001). Emergence agitation was significantly higher following sevoflurane (25.0%) than balanced anaesthesia (13.1%; P = 0.023).
CONCLUSION: The frequency of emergence agitation is significantly reduced by sub-Tenon lidocaine injection regardless of the modality of anaesthesia used.
Il-Sook Seo; Chae-Rim Seong; Gul Jung; Sang-Jin Park; Sae Yeon Kim; Myung Mi Kim
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  28     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-13     Completed Date:  2011-07-29     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  334-9     Citation Subset:  IM    
Department of Anesthesiology and Pain Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
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MeSH Terms
Anesthesia Recovery Period
Anesthesia, General / adverse effects*,  methods
Anesthetics, Combined / administration & dosage,  adverse effects,  therapeutic use
Anesthetics, Inhalation / administration & dosage,  adverse effects,  therapeutic use
Anesthetics, Intravenous / administration & dosage,  adverse effects,  therapeutic use
Anesthetics, Local / administration & dosage,  therapeutic use*
Child, Preschool
Follow-Up Studies
Lidocaine / administration & dosage,  therapeutic use*
Methyl Ethers / adverse effects,  therapeutic use
Ophthalmologic Surgical Procedures
Pain, Postoperative / complications,  prevention & control
Piperidines / administration & dosage,  adverse effects,  therapeutic use
Propofol / administration & dosage,  adverse effects,  therapeutic use
Psychomotor Agitation / epidemiology,  etiology,  prevention & control*
Strabismus / surgery
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 0/Methyl Ethers; 0/Piperidines; 132875-61-7/remifentanil; 137-58-6/Lidocaine; 2078-54-8/Propofol; 28523-86-6/sevoflurane
Comment In:
Eur J Anaesthesiol. 2012 Jan;29(1):52-3; author reply 53   [PMID:  21540745 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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