Authors:

Abstract

Objective: To compare effectiveness of inhalation sevoflurane and intravenous (IV) propofol anaesthesia with the laryngeal mask airway (LMA) in children undergoing surgeries below umbilicus.

Method: Sixty premedicated children 3-12 years old with the American Society of Anaesthesiologists physical status of I to II were enrolled and received either induction with sevoflurane 7% by face mask and maintained with a 50% oxygen and 50% nitrous oxide mixture followed by 1.7% sevoflurane or induction with 3 mg/kg propofol IV followed by infusion of 170µg/kg/min with LMA. Demographic data, induction time, number of attempts, LMA insertion, removal and recovery times, haemodynamic parameters, complications, Aldrete score and child’s behaviour score were recorded.

Results: Demographic data and induction time were similar for the 2 treatment groups. LMA insertion was successful at the first attempt in 93% with sevoflurane and 83% with propofol. LMA insertion, removal and recovery times were significantly longer in the propofol group (1.56±0.22, 5.89±1.23, 12.3±3.09 minutes respectively) than in the sevoflurane group (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively) (P<0.0001). Perioperative minor complications were comparable. Recovery milestones including Aldrete score were significantly higher in group S (9.03) than in group P (7.8) at 5 minutes (P<0.05) and comparable at 15 and 30 minutes. There was a greater incidence of excitatory phenomena with sevoflurane compared with propofol which was statistically significant (P<0.05). Haemodynamics were comparable in both groups.

Conclusions: Sevoflurane provided shorter LMA insertion, removal and recovery times than IV propofol in children undergoing minor surgeries below umbilicus with comparable perioperative complications. Agitation was significantly more with sevoflurane.

Sri Lanka Journal of Child Health, 2014; 43(2): 77-83

(Key words: Sevoflurane; laryngeal mask airway; propofol; paediatric)

DOI: http://dx.doi.org/10.4038/sljch.v43i2.7004

Keywords: Sevoflurane, laryngeal mask airway, propofol, paediatric