{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:23:59Z","timestamp":1792844639325,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T00:00:00Z","timestamp":1421107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Society for Paediatric Anaesthesia New Zealand and Australia (SPANZA)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,5]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n Emergence agitation (\n EA<\/jats:styled-content>\n ) is a common behavioral disturbance after sevoflurane anesthesia in children. Propofol 1\u00a0mg\u00b7kg\n \u22121<\/jats:sup>\n bolus at the end of sevoflurane anesthesia has had mixed results in reducing the incidence of\n EA<\/jats:styled-content>\n , whereas propofol infusion throughout anesthesia maintenance seems effective but is more complex to administer. If a simple, short transition to propofol anesthesia was found to be effective in reducing\n EA<\/jats:styled-content>\n , this could enhance the recovery of children following sevoflurane anesthesia. We therefore aimed to determine whether transition to propofol over 3\u00a0min at the end of sevoflurane anesthesia reduces the incidence of\n EA<\/jats:styled-content>\n in children.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this prospective randomized controlled trial, 230 children aged 1\u201312\u00a0years, undergoing magnetic resonance imaging (\n MRI<\/jats:styled-content>\n ) scans under sevoflurane anesthesia were randomized to receive either propofol 3\u00a0mg\u00b7kg\n \u22121<\/jats:sup>\n over 3\u00a0min (propofol group), or no propofol (control group), at the end of sevoflurane anesthesia.\n EA<\/jats:styled-content>\n was assessed by a blinded assessor using the Pediatric Emergence Anesthesia Delirium (\n PAED<\/jats:styled-content>\n ) scale and the Watcha scale until 30\u00a0min after emergence.\n EA<\/jats:styled-content>\n on the\n PAED<\/jats:styled-content>\n scale was defined as a\n PAED<\/jats:styled-content>\n score >12.\n EA<\/jats:styled-content>\n on the Watcha scale was defined as a score \u22653. Times to emergence, postanesthesia care unit (\n PACU<\/jats:styled-content>\n ) discharge, and discharge home were also recorded.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Data were analyzed for 218 children. The incidence of\n EA<\/jats:styled-content>\n was lower in the propofol group on both\n PAED<\/jats:styled-content>\n (29% vs 7%; relative risk\u00a0=\u00a00.25; 95% confidence interval 0.12\u20130.52;\n P<\/jats:italic>\n \u00a0<\u00a00.001) and Watcha (39% vs 15%; relative risk\u00a0=\u00a00.37; 95% confidence interval 0.22\u20130.62;\n P<\/jats:italic>\n \u00a0<\u00a00.001) scales. Duration and severity of\n EA<\/jats:styled-content>\n were also reduced in the propofol group. Preplanned subgroup analyses for midazolam premedication, preexisting cognitive or behavioral disturbance, and age group did not alter our findings. Emergence time and time in\n PACU<\/jats:styled-content>\n were both increased by a mean of 8\u00a0min in the propofol group (\n P<\/jats:italic>\n \u00a0<\u00a00.001) with no difference in time to discharge home.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Transition to propofol at the end of sevoflurane anesthesia reduces the incidence of\n EA<\/jats:styled-content>\n and improves the quality of emergence. There is a small increase in recovery time, but no delay in discharge home.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/pan.12617","type":"journal-article","created":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T23:52:29Z","timestamp":1421193149000},"page":"517-523","source":"Crossref","is-referenced-by-count":61,"title":["Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial"],"prefix":"10.1111","volume":"25","author":[{"given":"David","family":"Costi","sequence":"first","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"},{"name":"Discipline of Acute Care Medicine University of Adelaide Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Ellwood","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Waring","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Cyna","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia Women's and Children's Hospital Adelaide SA Australia"},{"name":"Discipline of Acute Care Medicine University of Adelaide 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