British Journal of Anaesthesia 1991; 67: 387-389

COMPARISON BETWEEN SEVOFLURANE AND HALOTHANE FOR PAEDIATRIC AMBULATORY ANAESTHESIA Y. NAITO, S. TAMAI, K. SHINGU, R. FUJIMORI AND K. MORI

We have compared the rapidity and quality of recovery after sevof/urane anaesthesia with those after halothane anaesthesia. Thirty unpremedicated paediatric outpatients undergoing pulseddye laser therapy for port-wine stains were allocated randomly to receive either halothane or sevof/urane anaesthesia. Each group received 60% nitrous oxide and 1.0-1.5 MAC of volatile agent in oxygen for approximately 40 min. Patients receiving sevof/urane exhibited more rapid emergence and a significantly shorter postoperative recovery time compared with those receiving halothane. No major adverse effects were encountered in each group. These results suggest that sevof/urane anaesthesia is preferable to halothane anaesthesia for paediatric ambulatory patients.

KEY WORDS Anaesthesia: paediatric. Anaesthetics, volatile: halothane, sevoflurane. Recovery: ambulatory surgery.

Sevoflurane has a low blood/gas partition coefficient and has been suggested to be useful for outpatients because of its rapid uptake and elimination [1]. It is not clear, however, if recovery from anaesthesia occurs more rapidly and completely in the ambulatory patient after this agent. To assess the usefulness of sevoflurane for outpatient anaesthesia in children, we have compared the rapidity and quality of recovery from general anaesthesia in paediatric patients who received either sevoflurane or halothane anaesthesia.

We studied 30 paediatric ambulatory patients (ages 1-7 yr) undergoing pulsed-dye laser therapy for port-wine stain of their face and neck region under general anaesthesia without premedication [2]. Patients were allocated randomly to two groups to receive either halothane or sevoflurane. The study was approved by the Ethics Committee of our university and informed verbal consent was obtained from parents before operation. The patients had been fasting at least 6 h and received no premedication. Anaesthesia was administered by the same anaesthetist. Induction of anaesthesia was by inhalation of 60 % nitrous oxide and 0.5-2.5 MAC of halothane (1.0 MAC = 0.8%) or sevoflurane (1.0 MAC = 1.7%) in oxygen via either a Jackson-Rees system (body weight < 10 kg) or a paediatric semi-closed circle system (body weight > 10 kg). Both agents were introduced gradually to the breathing system; concentrations were increased by increments of 0.5-1.0% every 2-3 breaths. After induction of anaesthesia, an i.v. cannula was inserted and atropine 0.01 mg/kg body weight was administered to prevent excessive salivation. Anaesthesia was maintained with 60% nitrous oxide and 1.0-1.5 MAC of the appropriate volatile agent in oxygen without tracheal intubation. Administration of nitrous oxide and volatile anaesthetic agent was discontinued at the end of operation. After awakYOSHIYUKI NAITO, M.D., SUNAO TAMAI, M.D., KOH SHINGU,

M.D. (Division of Emergency Medicine and Critical Care Medicine); KENJIRO MORI, M.D., F.C.ANAES. (Department of

Anesthesia); Kyoto University School of Medicine, Sakyo-ku, Kyoto 606, Japan. RYOSUKE FUJIMORI, M.D., Fujimori's Plastic

Surgery Clinic, Simogyo-ku, Kyoto 600, Japan. Accepted for Publication: April 4, 1991. Correspondence to Y.N.

Downloaded from http://bja.oxfordjournals.org/ at East Carolina University on July 12, 2015

PATIENTS AND METHODS

SUMMARY

BRITISH JOURNAL OF ANAESTHESIA

388

TABLE I. Details of the 30 patients studied and their anaesthesia. B.iut. = Body weight; Induction = time between induction and loss of eyelash reflex; Duration = duration of induction and maintenance of anaesthesia; Emergence = time from discontinuation of inhalation agent to opening eyes on request; Recovery = time from discontinuation of inhalation agent to discharge Patient No.

Age (yr)

M M F M F F M F M F F M F F F M M M F F F M F M F F F M F F

B.wt (kg)

Induction (min)

Duration (min)

Emergence (min)

Recovery (min)

16 10 14 13 20 9 10 10 10 17 18 22 17 16 20 14.8 (4.2)

3 3 2 3 3 3 4 5 3 5 3 3 3 3 3.3 (0.8)

22 31 54 46 76 44 55 45 25 32 23 53 45 35 31 41.1 (14.2)

11 4 7 9 16 10 8 10 10 6 12 10 10 11 9 9.5 (2.7)

157 151 111 120 132 125 165 110 120 141 160 115 170 160 124 137.4 (20.6)

2 5 5 3 3 4 2 3 2 2 1 5 2 5 5 3.2(1.4) ns

43 40 25 44 38 46 25 38 30 46 37 20 46 55 30 41.5(8.5) ns

5 6 5 5 4 4 5 3 3 5 3 5 2 5 5 4.3(1.1)

Comparison between sevoflurane and halothane for paediatric ambulatory anaesthesia.

We have compared the rapidity and quality of recovery after sevoflurane anaesthesia with those after halothane anaesthesia. Thirty unpremedicated paed...
209KB Sizes 0 Downloads 0 Views