Total intravenous propofol and remifentanil versus balanced anesthesia with sevofl urane and remifentanil for pediatric lower abdominal surgery

• Published in: Ain-Shams journal of anesthesiology Vol. 7; no. 3; pp. 434 - 440
• Main Authors: al-Safti, Umar M. T., Talat, Sahar M., Hamid, Ahmad M. S., Armanious, Simon H.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Ain Shams University, Faculty of Medicine, Department of Anesthesiology 2014
• Subjects: Pediatric anesthesia; الأطفال; التخدير; الجراحة
• ISSN: 1687-7934; 2090-925X

Background This study aimed to evaluate and compare the induction, the maintenance, hemodynamic responses and the recovery profi le of propofol-remifentanil combination (total intravenous anesthesia) and sevofl urane-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 sevofl urane 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, sevofl urane 2 vol% in 100% O2 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 defi ning feature in the P/R group only. Group P / R achieved rapid extubation in 12 min and was transferred t o th e 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 sevofl uraneremifentanil combination, with faster induction and recovery, although both techniques are considered to be safe and effective for providing anesthesia to pediatric patients.