A comparison of sevoflurane with halothane in outpatient adenotomy in children with mild upper respiratory tract infections.
OBJECTIVE
To investigate the efficacy and safety of sevoflurane compared with halothane in pediatric outpatient ear-nose-throat (ENT) surgery during the induction, maintenance, emergence, and recovery of anesthesia.


METHODS
Prospective, randomized, comparative, open-label study.


METHODS
ENT operating room and postoperative recovery room at a university medical center.


METHODS
41 ASA status I and II children between the ages of 2 to 10 years, with mild upper respiratory tract infection (URI).


METHODS
Induction and maintenance of anesthesia with either sevoflurane or halothane for outpatient adenotomy, otomicroscopy, and myringotomy.


RESULTS
Induction (means +/- SEM) was significantly shorter in the sevoflurane group (2.6 +/- 0.2 minutes) than in the halothane group (3.2 +/- 0.2 minutes). There was no difference between the two groups with regard to complications that occurred during the induction and maintenance period. The time to emergence and recovery was significantly shorter with sevoflurane than with halothane (means +/- SEM; time to extubation 9.9 +/- 0.98 minutes vs. 13.4 +/- 1.06 minutes, time to eye opening 12.9 +/- 1.6 minutes vs. 24.5 +/- 1.8 minutes, command response time 20.7 +/- 2.5 minutes vs. 36.4 +/- 2.8 minutes). No difference in the incidence of complications during emergence and recovery was found. Evaluation of recovery as assessed by a modified Aldrete score showed that children who had received sevoflurane reached higher scores in the first 30 minutes following the discontinuation of the anesthetic. The Pain/Discomfort Scale demonstrated a difference in the sevoflurane group, with more children being agitated and restless.


CONCLUSIONS
Sevoflurane provides a safe and rapid anesthetic induction with no differences in complications during the induction, maintenance, and emergence period. With sevoflurane, the time of emergence and recovery was significantly shorter. The characteristics of sevoflurane as evaluated in the present study make it a suitable anesthetic in pediatric outpatient surgery even in the presence of mild URI.
Rieger
A
A
Department of Anesthesiology and Operative Intensive Care Medicine, Benjamin Franklin Medical Center, Free University of Berlin, Germany.
Schröter
G
G
Philippi
W
W
Hass
I
I
Eyrich
K
K
D000234:Adenoids / Q000601:surgery*; D000553:Ambulatory Care; D018685:Anesthetics, Inhalation; D002648:Child; D002675:Child, Preschool; D004987:Ethers; D006221:Halothane; D006801:Humans; D008738:Methyl Ethers; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000601:surgery*; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane