Pediatric anesthesia & critical care
Comparative Assessment of Cortical Hemodynamic Activity in Children Undergoing Anesthesia With Sevoflurane and Propofol: A Functional Near Infrared Spectroscopy Based Randomized Controlled Trial
Authors' conclusion
The increased frontal cortical activation with sevoflurane may contribute to a higher incidence of emergence delirium in children compared to propofol.
Study context
- Population
- Children aged 3–10 undergoing urologic and orthopedic surgeries
- Participants
- 74 children
- Comparison
- Propofol vs sevoflurane anaesthesia
- Propofoln = 37
- Sevofluranen = 37
- Primary endpoint
- Frontal cortex hemodynamic activity (functional near-infrared spectroscopy (fNIRS)) during anaesthesia in relation to emergence delirium
Methodological detailspilot
- Pilot
Primary result
As reported in the abstract
Frontal cortex fNIRS activity vs emergence delirium (ED)
- Propofol induction: children without ED showed greater left frontal activation (channel 4; t = 2.30, p < 0.005); those with ED showed deactivation; no differences at extubation
- Sevoflurane induction: children without delirium showed greater deactivation in channel 13 (t = −2.252, p < 0.05), channel 2 (t = −2.252, p < 0.05) and channel 17 (t = −3.15, p < 0.05); no differences at extubation
- Children with ED: sevoflurane vs propofol, significantly less deactivation (more activation) at induction, channel 4 (t = −5.756, p < 0.005)
- Children with ED: sevoflurane vs propofol, significantly less deactivation (more activation) at extubation, channel 2 (t = −6.877, p < 0.05)
Further findings
Emergence delirium incidence
Original publication
Comparative Assessment of Cortical Hemodynamic Activity in Children Undergoing Anesthesia With Sevoflurane and Propofol: A Functional Near Infrared Spectroscopy Based Randomized Controlled Trial. Paediatr Anaesth. Published 9 January 2026. doi:10.
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