Impact of Propofol Administered before Extubation on Respiratory Adverse Events in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy: A Randomized Controlled Trial.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Author(s): Liao R;Liao R; Zhou Z; Zhou Z; Wang X; Wang X; Shao H; Shao H
  • Source:
    British journal of hospital medicine (London, England : 2005) [Br J Hosp Med (Lond)] 2024 Nov 30; Vol. 85 (11), pp. 1-15. Date of Electronic Publication: 2024 Nov 18.
  • Publication Type:
    Journal Article; Randomized Controlled Trial
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: MA Healthcare Country of Publication: England NLM ID: 101257109 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1750-8460 (Print) Linking ISSN: 17508460 NLM ISO Abbreviation: Br J Hosp Med (Lond) Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : MA Healthcare, c2005-
    • Subject Terms:
    • Abstract:
      Aims/Background Perioperative respiratory adverse events (PRAEs) are common in pediatric anesthesia, especially in otolaryngology procedures. In this randomized controlled trial, we investigated the impact of administering propofol before extubation on PRAEs in pediatric patients undergoing tonsillectomy and adenoidectomy. Methods We enrolled children aged 3 to 8 years old, of American Society of Anesthesiologists (ASA) classes I to III, scheduled for tonsillectomy, and randomly divided them into propofol and control groups. The subjects in the propofol group received multiple small doses of propofol (0.5 mg/kg per dose, total 1-2 mg/kg) until the patient resumed regular spontaneous breathing and exhibited no bodily movements. The subjects in the control group received 0.15 mL/kg of saline. The primary outcome was the rate of PRAEs, such as laryngospasm, bronchospasm, breath-holding spell, severe coughing, desaturation, and airway obstruction, post-extubation. The secondary outcomes were the extubation time, pre-extubation Richmond Agitation-Sedation Scale (RASS) score, end-tidal sevoflurane concentration at extubation, incidence of postoperative agitation, time to consciousness, and Face, Legs, Activity, Cry, and Consolability (FLACC) pain score in the recovery room. Results were reported with risk ratios (RR) and their 95% confidence intervals (CI), as well as the p -values indicating statistical significance. Results A total of 239 patients were included, including 119 in the propofol group and 120 in the control group. Our findings indicated no significant difference in the rate of PRAEs between the two groups (5.9% vs 10.8%, RR: 0.54, 95% CI: 0.23 to 1.31, p = 0.17). However, the propofol group showed a notable decrease in moderate to severe coughs (13.4% vs 60.0%, RR: 0.22, 95% CI: 0.14 to 0.36, p < 0.001) and postoperative agitation (4.2% vs 60.8%, RR: 0.07, 95% CI: 0.03 to 0.17, p < 0.001). Conclusion This trial demonstrated that while administering repeated small doses of propofol before extubation does not significantly reduce respiratory adverse events in children undergoing tonsillectomy and adenoidectomy, it does significantly reduce the incidence of severe coughing, improving postoperative recovery and clinical outcomes. Moreover, propofol helps reduce postoperative agitation, enhancing the safety and effectiveness of postoperative care, and maintaining its valuable clinical role in postoperative management. Clinical Trial Registration ClinicalTrials.gov (NCT05769842).
    • Contributed Indexing:
      Keywords: children; extubation; perioperative respiratory adverse events; propofol
    • Molecular Sequence:
      ClinicalTrials.gov NCT05769842
    • Accession Number:
      YI7VU623SF (Propofol)
      0 (Anesthetics, Intravenous)
    • Publication Date:
      Date Created: 20241202 Date Completed: 20241202 Latest Revision: 20241202
    • Publication Date:
      20241204
    • Accession Number:
      10.12968/hmed.2024.0431
    • Accession Number:
      39618204