Propofol and halothane versus sevoflurane in paediatric day-case surgery: induction and recovery characteristics†

Mar 20, 2003British journal of anaesthesia

How propofol and halothane compare to sevoflurane in starting and recovering from children's day surgery

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Abstract

The mean time required for induction with propofol was 3.1 minutes, compared to 5 minutes for sevoflurane.

Excitatory movement occurred more frequently during induction with sevoflurane.
The recovery time was shorter for sevoflurane at 23.2 minutes, versus 26.4 minutes for propofol/halothane.
The incidence of delirium was higher in the sevoflurane group compared to the propofol/halothane group.
Postoperative nausea and vomiting were significantly more common in the sevoflurane group.
There was no difference in the time spent on the postoperative ward before discharge.

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BACKGROUND: The aim of this study was to compare the induction and recovery characteristics associated with propofol induction and halothane maintenance with sevoflurane anaesthesia in paediatric day surgery.

METHODS: In total, 322 children were assigned randomly to i.v. propofol induction and halothane/nitrous oxide maintenance or sevoflurane/nitrous oxide alone. The patients' age, sex, and type of surgery were recorded, as were the times required for anaesthetic induction, maintenance, recovery and time to discharge home. Postoperative nausea and vomiting, and the incidence of adverse events during induction and recovery were also noted.

RESULTS: No significant differences were detected in age, sex, type of surgery performed or intraoperative opioid administration. Excitatory movement was more common during induction with sevoflurane. The mean time required for induction with propofol was 3.1 min compared with 5 min in the sevoflurane group (P<0.001). The recovery time was shorter in the sevoflurane group compared with propofol/halothane (23.2 vs 26.4 min, P<0.002). The incidence of delirium in recovery was greater in the sevoflurane group (P<0.001). There was no difference between groups in the time spent on the postoperative ward before discharge home. On the postoperative ward the incidence of both nausea and vomiting was significantly higher in the sevoflurane group (P=0.034). Five children were admitted to hospital overnight, none for anaesthetic reasons.

CONCLUSIONS: The increased incidence of adverse events during induction, postoperative nausea and vomiting and postoperative delirium in the sevoflurane group suggests that sevoflurane is not ideal as a sole agent for paediatric day case anaesthesia.

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Propofol and halothane versus sevoflurane in paediatric day-case surgery: induction and recovery characteristics†

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