| 40 YEARS AGO |
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| Year : 2014 | Volume
: 7
| Issue : 3 | Page : 434-440 |
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Total intravenous propofol and remifentanil versus balanced anesthesia with sevoflurane and remifentanil for pediatric lower abdominal surgery
Omar M.T. Elsafti, Ahmed M.S. Hamed, Sahar M Talaat, Simon H Armanious
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Correspondence Address:
Ahmed M.S. Hamed
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1687-7934.139589
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Background
This study aimed to evaluate and compare the induction, the maintenance, hemodynamic responses and the recovery profile of propofol-remifentanil combination (total intravenous anesthesia) and sevoflurane-remifentanil under the Bispectral index for pediatric patients undergoing short lower abdominal surgery.
Materials and methods
Sixty ASA physical status I and II patients aged 3-10 years scheduled for elective lower abdominal procedure were assigned to receive either the propofol and remifentanil combination (group P/R = 30 patients) or sevoflurane and remifentanil (group S/R = 30 patients) under Bispectral index monitoring. In both groups, anesthesia was started with remifentanil infusion (0.5 μg/kg/min) for 2 min. In the P/R group, a bolus dose of propofol 2 mg/kg was given, and then the infusion was started (7.5 mg/kg/h) and reduced gradually to 3 mg/kg/h. In the S/R group, sevoflurane 2 vol% in 100% O 2 was added and increased gradually to 8 vol%, and then reduced to 4, 3, 2 vol%.
Results
Induction of anesthesia was rapid in the P/R group (2.3 ± 0.7 min) compared with the S/R group (2.6 ± 1.3 min). Hypotension occurred after induction 10% in the P/R group versus 30% in the S/R group. Bradycardia was a defining feature in the P/R group only. Group P/R achieved rapid extubation in 12 min and was transferred to the postanesthesia care unit, in 17 min compared with 15 and 20 min, respectively, in the S/R group.
Conclusion
This study indicates that the propofol-remifentanil combination is superior to the sevoflurane-remifentanil combination, with faster induction and recovery, although both techniques are considered to be safe and effective for providing anesthesia to pediatric patients. |
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