Time to extubation in infants undergoing pyloromyotomy -- isoflurane inhalation vs remifentanil infusion.
BACKGROUND
Infantile hypertrophic pyloric stenosis (IHPS) associated with metabolic alkalosis, could induce late anesthesia recovery, especially when opioids are used. The aim of this study was to compare the time of extubation and the quality of perioperative analgesia in infants scheduled for pyloromyotomy, receiving either isoflurane inhalation or remifentanil infusion.


METHODS
Thirty full-term infants scheduled for pyloromyotomy were prospectively studied. A standardized anesthetic induction was performed. For maintenance of anesthesia, infants were randomly allocated to receive either isoflurane 0.75% of inspired concentration (GI n = 15), or remifentanil as a continuous infusion of 0.4 microg x kg(-1) x mn(-1) (GR n = 15). At the beginning of skin closure, the anesthetic was discontinued and 15 mg x kg(-1) of paracetamol administered. Non parametric tests were used in statistical analysis.


RESULTS
The time to extubation was similar in both groups. The intraoperative heart rate was significantly lower in the GR group.


CONCLUSIONS
Remifentanil provided better intraoperative analgesia than isoflurane in infants undergoing pyloromyotomy without increasing time to extubation.
Ben Khalifa
Sonia
S
Department of Anesthesia and Intensive Care, Children's Hospital, Tunis.
Blidi
Sami
S
Trifa
Mehdi
M
Skhiri
Alia
A
Drira
Mehdi
M
Regaya
Tarek
T
Fekih Hassen
Amjed
A
D000082:Acetaminophen / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000627:therapeutic use*; D008297:Male; D019990:Perioperative Care; D010880:Piperidines / Q000627:therapeutic use*; D011446:Prospective Studies; D046248:Pyloric Stenosis, Hypertrophic / Q000601:surgery; D000077208:Remifentanil; D016037:Single-Blind Method; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000082:Acetaminophen; D007530:Isoflurane; D000077208:Remifentanil