Sevoflurane versus halothane: postoperative maladaptive behavioral changes: a randomized, controlled trial.
BACKGROUND
The authors conducted a double-blind, randomized, controlled trial to determine whether the use of sevoflurane in children undergoing anesthesia and surgery results in a higher incidence of postoperative maladaptive behavioral changes as compared with halothane.


METHODS
Children and their parents (n = 102) were randomly assigned to either a halothane group (n = 50) or a sevoflurane group (n = 52). The intraoperative anesthetic protocol was strictly controlled, and the postoperative analgesic consumption and pain levels were recorded. The effect of the group assignment on emergence status and maladaptive postoperative behavioral changes was assessed both by validated psychological measures and physiologic instruments (actigraphy) on postoperative days 1-7. Anxiety of the parent and child was also assessed, as was the child's postoperative recovery (Recovery Inventory).


RESULTS
There were no group differences in preoperative state anxiety, postoperative analgesic requirements, postoperative pain, or the incidence of emergence delirium (P = not significant). Two-way repeated-measures analysis of variance showed no group differences in the incidence of postoperative maladaptive behaviors (F4,72 = 0.60, P = 0.701) or actigraphic variables such as percent sleep, number of night awakenings, and night awakenings that lasted for more than 5 min (P = not significant).


CONCLUSIONS
The authors found no increased incidence of emergence delirium, maladaptive postoperative behavior changes, or sleep disturbances in children undergoing anesthesia with sevoflurane as compared with halothane.
Kain
Zeev N
ZN
Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. zeev.kain@yale.edu
Caldwell-Andrews
Alison A
AA
Weinberg
Megan E
ME
Mayes
Linda C
LC
Wang
Shu-Ming
SM
Gaal
Dorothy
D
Saadat
Haleh
H
Maranets
Inna
I
D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000523:psychology; D002675:Child, Preschool; D003693:Delirium / Q000139:chemically induced / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006221:Halothane / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D009043:Motor Activity / Q000187:drug effects; D010149:Postoperative Pain / Q000523:psychology; D011183:Postoperative Complications / Q000139:chemically induced* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D000077149:Sevoflurane; D012890:Sleep / Q000187:drug effects; D013694:Temperament / Q000187:drug effects; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane