Paediatric anaesthesia & critical care
Pre‐Extubation Low‐Dose Propofol in Pediatric Ear, Nose, and Throat Procedures: A Meta‐Analysis With Trial Sequential Analysis
Authors' conclusion
Our findings suggest that pre-extubation propofol probably reduces the incidence of EA in pediatric ENT surgery, supported by moderate-certainty evidence, and may lower EA severity measured by PAED scale scores, for which the certainty of evidence was very low.
Study context
- Population
- Children undergoing ear, nose, and throat (ENT) procedures6 randomized controlled trials (RCTs) in meta-analysis
- Participants
- 414 children
- Comparison
- Low-dose propofol vs placebo before extubation
- Outcome
- Laryngospasm, severity of emergence agitation (EA) (Pediatric Anesthesia Emergence Delirium (PAED) scale score) and incidence of EA
Methodological detailstrial sequential analysis, random-effects models, 10 RCTs included in the review
- Trial sequential analysis
- Random-effects models
- 10 RCTs included in the review
Pooled result
As reported in the abstract
Propofol vs PlaceboRelative risk (95% CI)
Incidence of EA; moderate certainty; TSA confirmed robustness
0.57(0.42–0.78)
Propofol vs PlaceboMD (95% CI)
Severity of EA (PAED); very low certainty; TSA confirmed robustness
−3.94(−5.74 to −2.13)
Further pooled results
Time to extubation
- Slightly longer with propofol vs control
- MD 1.8 min (95% CI 1.4-2.3)
- Trial sequential analysis (TSA) confirmed robustness
- Moderate certainty of evidence
Time to recovery
- No difference, propofol vs control
- MD 0.9 min (95% CI −1.9 to 3.6)
Post-anesthesia care unit (PACU) LOS
- No difference, propofol vs control
- MD −0.63 min (95% CI −3.2 to 1.9)
Original publication
Pre‐Extubation Low‐Dose Propofol in Pediatric Ear, Nose, and Throat Procedures: A Meta‐Analysis With Trial Sequential Analysis. Paediatr Anaesth. Published 12 August 2026. doi:10.
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