Syndrome of Postnarcosis Excitation and its Prophylaxis in Anesthesia with Sevoflurane in Pediatric Oncology

S.V. Tumanyan, E.Yu. Semiletkina, D.A. Rozenko

Rostov Research Oncology Institute, Russian Federation Ministry of Healthcare of the Russian Federation, Rostov-on-Don

For correspondence: Tumanyan Sergey Vartanovich — MD, professor, head of the Department of Anesthesiology and Reanimatology of the Rostov Research Oncology Institute, Federal Ministry of Health, Rostov-on-Don; e-mail: stv53@mail.ru

For citation: Tumanyan SV, Semiletkina EYu, Rozenko DA. Syndrome of Postnarcosis Excitation and Its Prophylaxis in Anesthesia with Sevoflurane in Pediatric Oncology. Intensive Care Herald. 2017;2:31–36.


Sevoflurane is the «gold standard» in pediatric anesthesia, because Does not irritate the upper respiratory tract, has a cardioprotec- tive effect, is easily controlled. Along with this, sevoflurane also has side effects, of which the most interesting is the syndrome of post- narcotic excitement, expressed by expressed anxiety, motor excitement, negativism. For its prevention, dexmedetomidine can be used. The goal is to select the optimal method of prevention of post-nasal exacerbation syndrome (SPNV) in young children with oncological pathology with sevoflurane inhalation anesthesia. Materials and methods. 90 children with oncological pathology aged from 1 year to 4 years, body weight from 9 to 18 kg, physical status according to ASA II–III were examined. Depending on the method of prevention of SPNV, children were divided into three groups: 1st group of children who had undergone sevoflurane inhalation anesthesia; 2nd group of children who, after anesthesia with sevoflurane, received propofol, 3rd group — children who, prior to anesthesia with sevoflurane, intranasally injected dexmedetomidine. Conclusions. Administration of propofol at the end of inhalation with sevoflurane prevents the development of SPNV in children in 82.8% of cases, prolongs the phase of medicamentous sedation, reduces hypersympathicoto- nia. Short-term depression of respiration in response to the administration of propofol requires 100 % oxygen inhalation. Intranasal administration of dexmedetomidine 30 minutes prior to the onset of anesthesia prevents the development of SPNV in children after inhalation anesthesia with sevoflurane in 90% of cases.

Keywords: postnarcosis excitation syndrome, children, dexmedetomidine, sevoflurane, oncology

Received: 10.03.2017


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