Post Extubation Delirium and End-tidal Sevoflurane Concentration

Association Between Post Extubation Delirium and Pre-extubation End-tidal Sevoflurane Concentration in Children

The purpose of this study is to determine whether the incidence of emergence delirium will be reduced when end-tidal concentration of sevoflurane decreases.

Sevoflurane induction and maintenance were selected. Intubation was performed after lidocaine spray on vocal cord. After that, an effective caudal or brachial plexus block was performed. End-tidal concentration of sevoflurane was maintained at 2.5%. Spontaneous respiratory was maintained. Sevoflurane was stopped after the end of surgery. Patients were randomly assigned to 2 groups: high concentration group (Group HC, end-tidal concentration of sevoflurane when extubating >=0.5%) and low concentration group (Group LC, end-tidal concentration of sevoflurane when extubating <0.5%). Patients in Group LC were extubated when they coughed or purposeful movement appeared. The patients whose end-tidal concentration of sevoflurane >= 0.5% were excluded. Patients in Group HC were extubated when any of the criteria was met: 1.the patient coughed or purposeful movement appeared 2.end-tidal concentration of sevoflurane decreased to 0.5%. A trained nurse (blind to groups) recorded PAEDs scores in PACU.

Inclusion Criteria:

• Age 2-7 years
• ASA I - II
• Estimated surgery time < 2 hours
• Sevoflurane induction and maintenance along with caudal block or Axillary Block

Exclusion Criteria:

• Craniofacial anomalies
• Difficult exposure of the vocal cordS
• Obesity
• Asthma
• Invalid caudal block or axillary block