Sevoflurane causes more postoperative agitation in children than does halothane

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Abstract

Background:

An agitated recovery may occur after inhalation anesthesia. The aim of the present study was to assess the recovery quality after mask anesthesia with either halothane or sevoflurane in children.

Methods:

Sixty-two children, 8 months to 18 years of age, scheduled for minor surgery, were randomly assigned to receive either halothane or sevoflurane. The patients were premedicated with midazolam and anesthesia was induced iv with propofol or by inhalation and maintained with halothane or sevoflurane in N2O/O2 via face mask. Recovery was assessed by a "blinded" observer using a postanesthetic recovery score. Agitation and pain were judged using a visual analog scale. The incidence of vomiting was noted. The day after anesthesia older children and parents of younger children were interviewed about their experience of the anesthesia and recovery period.

Results:

There were no differences between groups in respect of age, weight, length, or duration of surgery or inhalational gas exposure. Median time from end of administration of inhalational agent to spontaneous eye opening was less after sevoflurane (25 min) than after halothane (48 min), (P < 0.01). Likewise, recovery was faster after sevoflurane anesthesia (P < 0.05). Agitation, but not pain, occurred more frequently after sevoflurane than after halothane (P < 0.05) and agitation was significantly more common in younger children. There was no difference in duration of hospital stay between day-care patients in the two groups.

Conclusion:

Early postanesthetic agitation and recovery was faster after mask anesthesia with sevoflurane than after halothane. There was a higher incidence of agitation in younger children, without correlation to pain.

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