Sevoflurane and emergence behavioral changes in pediatrics

Sevoflurane has rapidly replaced halothane as the inhaled anesthetic agent of choice for the pediatric population. Benefits of sevoflurane use include a quick induction and emergence from anesthesia, a nonpungent odor, which allows for mask induction, and decreased airway irritation, which results in a decrease in the incidence of bronchospasm and laryngospasm. Despite the positive aspects of sevoflurane, there are several side effects, including seizures during induction and maintenance, elevations in plasma inorganic fluoride and compound A concentrations, and an increased incidence of emergence delirium when compared to halothane. The purpose of this article is to inform perianesthesia nurses of the common complication of emergence behavioral changes associated with sevoflurane.