title: Sevoflurane versus halothane: postoperative maladaptive behavioral changes: a randomized, controlled trial.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. zeev.kain@yale.edu
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
authors.forename: Alison A
authors.initials: AA
authors.lastname: Caldwell-Andrews
authors.forename: Megan E
authors.initials: ME
authors.lastname: Weinberg
authors.forename: Linda C
authors.initials: LC
authors.lastname: Mayes
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Wang
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gaal
authors.forename: Haleh
authors.initials: H
authors.lastname: Saadat
authors.forename: Inna
authors.initials: I
authors.lastname: Maranets
mesh_terms: 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
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane