外科と麻酔のジャーナル

概要

The Preventive Effect of Subhypnotic Dose of Propofol in Preventing Laryngospasm in Children undergoing Adeno-tonsillectomy in Addis Ababa Hospitals, Addis Ababa Ethiopia. A Prospective Cohort Study

Geresu Gebeyehu, Betelhem Ayele, Adugna Aregawi, Zewetir Ashebir

Introduction: Laryngospasm is defined as the sustained closure of the vocal cords, well-known problem typically occurring immediately following tracheal extubation. Incidence of laryngospasm is as high as 25% in patients undergoing tonsillectomy and adenoidectomy. Propofol is an intravenous drug use for the induction of general anesthesia and for moderate to deep sedation, which is also known to strongly suppress airway responses. At a lower concentration than the anesthetic dose, propofol may help to reduce or prevent laryngospasm after extubation in pediatric patients. This study assessed the effectiveness of propofol in preventing laryngospasm during adeno-tonsillectomy surgery under general anesthesia.

Methods: This prospective cohort study conducted on 66 pediatric patients aged up to 9 years and underwent elective adenotonsilectomy under general anesthesia from december 2019-March 2020 at Tikur anbessa specialized hospital, Yekatit 12 hospital and Menilke hospital. The data was recorded as group P if anesthesia providers gave propofol 0.5 mg/kg one minute before extubation or group C if the anesthesia provider just extubate without giving propofol. The incidence and severity of laryngospasm was compared between the two groups. Moreover, vital signs were compared among the two groups. Data was analyzed using student t test and Mann–Whitney U test for normally and non-normally distributed data respectively and chi-square test for categorical data. P-value less than 0.05 considered as statistically significant.

Results: The occurrence of laryngospasm between propofol group and control group was 9.1% and 42.4% respectively (p<0.05). The comparison of severity of laryngospasm and vital sign changes showed no significant difference between the groups. (p>0.05).

Conclusion: Subhypnotic dose of propofol (0.5 mg/kg) decreases the occurrence of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy. We recommend anesthetists to use 0.5 mg/kg of propofol one minute before extubation to prevent post extubation laryngospasm.