[Propofol-remifentanil versus sevoflurane-remifentanil for anesthesia for pediatric procedures in infants, children and adolescents].
BACKGROUND
The aim of this study was to compare total intravenous anaesthesia (TIVA) using propofol and remifentanil (P/R-group) and balanced anaesthesia (BA) using sevoflurane and remifentanil (S/R-group) for paediatric surgery.


METHODS
A total of 120 patients aged 6 months to 16 years scheduled for elective minor lower abdominal surgery were randomly assigned to receive either propofol (5-10 mg/kg/h) and remifentanil (0.125-1.0 microgram/kg/min) or sevoflurane (1.0-1.5 MAC) and remifentanil (0.125-1.0 microgram/kg/min). Perioperative haemodynamics as well as recovery and discharge times, PONV and side-effects were studied. The patients vigilance, comfort and pain intensity were assessed postoperatively using the objective pain discomfort scale, the Steward post-anaesthetic recovery score and a visual analogue scale.


RESULTS
Postoperative recovery (9.0 vs 11.6 min) and extubation times (11.8 vs. 15.0 min) as well as the time taken until a Steward post-anaesthetic recovery score > 3/4 (15.2 vs. 21.4 min) was reached were significantly shorter in the P/R-group. However, the length of time until discharge to the ward, postoperative comfort, pain intensity and analgesic requirements as well as PONV were comparable in both groups.


CONCLUSIONS
With regards to the investigated parameters, TIVA with propofol and remifentanil is equally effective as BA with sevoflurane and remifentanil in paediatric patients. However, considering the selected dosing regimen, recovery times were significantly shorter for children after TIVA.
Schmidt
J
J
Klinik für Anästhesiologie der Friedrich-Alexander-Univrsität Erlangen-Nürnberg, Krankenhausstrasse 12, 91054 Erlangen. joachim.schmidt@stud.uni-erlangen.de
Fechner
J
J
Fritsch
B
B
Schmitz
B
B
Carbon
R
R
Rösch
W
W
Albrecht
S
S
D000005:Abdomen / Q000601:surgery; D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000293:Adolescent; D000769:Anesthesia, Inhalation / Q000009:adverse effects; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D010880:Piperidines / Q000009:adverse effects; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D015742:Propofol / Q000009:adverse effects; D000077208:Remifentanil; D000077149:Sevoflurane
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol