Comparison of cardiovascular changes during anaesthesia and recovery from propofol-alfentanil-nitrous oxide and thiopentone-halothane-nitrous oxide anaesthesia in children undergoing otolaryngological surgery

Acta Anaesthesiol Scand. 1993 Nov;37(8):737-41. doi: 10.1111/j.1399-6576.1993.tb03800.x.

Abstract

Propofol/alfentanil anaesthesia was compared with thiopentone/halothane anaesthesia in 86 midazolam-atropine premedicated children undergoing minor otolaryngological surgery. The study was randomised, and evaluation of recovery from anaesthesia was double-blind. The children were divided into two age groups: 1-3 years and 4 years and older. Particular attention was paid to ECG changes during anaesthesia and to the rapidity of recovery. One minute after alfentanil 15 micrograms.kg-1, the children in the propofol group received propofol 2.0-3.0 mg.kg-1 followed by propofol infusion 15 mg.kg-1.h-1. In addition, 0.1% suxamethonium 6 mg.kg-1.h-1 was infused during operation. The other children received thiopentone 5-7 mg.kg-1 followed by halothane (0.5-2%) immediately after endotracheal intubation. Junctional rhythm occurred in 5-35% of the children independent of anaesthesia method, and ventricular ectopic beats were seen in 20% of the older children during halothane anaesthesia. Recovery with respect to times to eye opening or response to verbal contact was significantly faster after propofol/alfentanil anaesthesia than after thiopentone/halothane anaesthesia in the older but not in the younger age group. Furthermore, in the younger age group significantly more crying occurred after propofol/alfentanil than after thiopentone/halothane anaesthesia. On the basis of this study, thiopentone/halothane anaesthesia is recommended for children aged 1-3 years and propofol/alfentanil anaesthesia for older children undergoing adenoidectomy and/or tonsillectomy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alfentanil*
  • Anesthesia*
  • Blood Pressure / physiology
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Electrocardiography
  • Halothane*
  • Heart Rate / physiology
  • Humans
  • Infant
  • Nitrous Oxide*
  • Otorhinolaryngologic Diseases / epidemiology
  • Otorhinolaryngologic Diseases / physiopathology
  • Otorhinolaryngologic Diseases / surgery*
  • Propofol*
  • Thiopental*

Substances

  • Alfentanil
  • Thiopental
  • Nitrous Oxide
  • Halothane
  • Propofol