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Anesth Analg 2005;100:959-963
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000147667.06156.DF

PEDIATRIC ANESTHESIA

Recovery After Anesthesia for Short Pediatric Oncology Procedures: Propofol and Remifentanil Compared with Propofol, Nitrous Oxide, and Sevoflurane

Hilary R. Glaisyer, MRCP, FRCA, and Michael R. J. Sury, FRCA

Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London, UK

Address correspondence and reprint requests to Hilary R. Glaisyer, MRCP, FRCA, Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, United Kingdom. Address e-mail to glaish{at}gosh.nhs.uk or hrg{at}doctor.com.

Anesthesia techniques in children undergoing short painful oncology procedures should allow rapid recovery without side effects. We compared the recovery characteristics of two anesthetic techniques: propofol with sevoflurane and nitrous oxide and a total IV technique using propofol and remifentanil. Twenty-one children, undergoing two similar painful procedures within 2 wk were studied in a single-blind manner within patient comparison. The order of the techniques was randomized. Propofol and remifentanil involved bolus doses of both propofol 3–5 mg/kg and remifentanil 1–4 µg/kg. Propofol with sevoflurane and nitrous oxide involved propofol 3–5 mg/kg with 2%–8% sevoflurane and 70% nitrous oxide. The primary outcome variable was the time taken to achieve recovery discharge criteria; other recovery characteristics were also noted. The mean age of the children was 6.5 yr (range, 2.5–9.8 yr). Nineteen had lymphoblastic leukemia and two had lymphoma. All children had intrathecal chemotherapy and one had bone marrow aspiration. Most procedures lasted <4 min. The mean time to achieve recovery discharge criteria was appreciably shorter after propofol and remifentanil than propofol with sevoflurane and nitrous oxide by nearly 19 min (P = 0.001). All other time comparisons had similar trends and statistical differences. Seven parents expressed a preference for the propofol and remifentanil technique compared with one preferring propofol with sevoflurane and nitrous oxide. Children are apneic during the procedure and require respiratory support from an anesthesiologist. Discharge readiness from the recovery ward was achieved on average 19 min earlier after propofol with remifentanil compared with the combination of propofol, sevoflurane and nitrous oxide. Parents more often preferred propofol with remifentanil.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.