title: Sevoflurane-remifentanil vs isoflurane-remifentanil for the surgical correction of craniosynostosis in infants.
abstract: BACKGROUND
  The aim of the present study was to compare the efficacy of isoflurane-remifentanil and sevoflurane-remifentanil combinations during neurosurgical correction craniosynostosis.
  
  
  METHODS
  Twenty-two infants with craniosynostosis received a slow bolus of remifentanil followed by continuous infusion. The infants were randomly divided into two groups: remifentanil followed by sevoflurane (the 'sevoflurane group'), and remifentanil followed by isoflurane (the 'isoflurane group'). We monitored electrocardiogram (ECG), heart rate (HR), invasive arterial blood pressure (IABP), pulse oximetry saturation (SpO(2)), endtidal CO(2) (P(ECO(2))), inspired fraction of oxygen (FiO(2)) and endtidal volatile agent (PE volatile agent) at 12 time points, from the beginning of surgery (T0) until the cessation of drugs (T11). The volatile agent was stopped prior to skin suture and the remifentanil infusion after skin closure. Subsequently, we evaluated recovery time of spontaneous breathing and spontaneous eye opening and time of extubation at 5, 10, and 15 min after extubation, the Steward Recovery Score (SRS) was assessed. Patients were then transferred to the Pediatric Intensive Care Unit (PICU).
  
  
  RESULTS
  During the surgical procedure the hemodynamic parameters between the two groups did not show statistically significant differences. There were also no significant differences in terms of awakening time or SRS.
  
  
  CONCLUSIONS
  The rapid recovery of the children (confirmed by their high values of SRS) makes it possible to reliably assess the patient's neurological condition immediately after surgery.
authors: Department of Anesthesiology, Pediatric Neuroanesthesiology, Catholic University Medical School, Rome, Italy. domenicopietrini@inwind.it
authors: Domenico
authors: D
authors: Pietrini
authors: Francesca
authors: F
authors: Ciano
authors: Elia
authors: E
authors: Forte
authors: Federica
authors: F
authors: Tosi
authors: Filippo
authors: F
authors: Zanghi
authors: Francesco
authors: F
authors: Velardi
authors: Concezio
authors: C
authors: DI Rocco
authors: Antonio
authors: A
authors: Chiaretti
authors: Elena
authors: E
authors: Caresta
authors: Marco
authors: M
authors: Piastra
mesh_terms: D000762:Anesthesia Recovery Period; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000032:analysis; D003398:Craniosynostoses / Q000601:surgery*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects; D010880:Piperidines / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D012119:Respiration; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D002245:Carbon Dioxide; D000077149:Sevoflurane; D007530:Isoflurane; D000077208:Remifentanil; D010100:Oxygen