A COMPARISON OF SEVOFLURANE WITH HALOTHANE IN OUTPATIENT ADENOTOMY INCHILDREN WITH MILD UPPER RESPIRATORY-TRACT INFECTIONS

Study Objective: To investigate the efficacy and safety of sevoflurane compared with halothane in pediatric outpatient ear-nose-throat (ENT) surgery during the induction, maintenance emergence, and recovery of anesthesia. Design: Prospective, randomized, comparative, open-label s tudy. Setting: ENT operating room and postoperative recovery room at a university medical center. Patients: 41 ASA status I and II children between the ages of 2 to 10 years, with mild upper respiratory tract i nfection (URI). Interventions: Induction and maintenance of anesthesia with either sevoflurane or halothane for outpatient adenotomy, otomic roscopy, and myringotomy. Measurements and Main Results: Induction (me an +/- SEM) was significantly shorter the sevoflurane group (2.6 +/- 0 .2 minutes) than in the halothane group (3.2 +/- 0.2 minutes). There w as no difference between the two groups with regard to complications t hat occurred during the induction and maintenance period. The time to emergence and recovery was significantly shorter with sevoflurane than with halothane (means +/- SEM; time to extubation 9.9 +/- 0.98 minute s vs. 13.4 +/- 1.06 minutes, time to eye opening 12.9 +/- 1.6 minutes vs. 24.5 +/- 1.8 minutes, command response time 20.7 +/- 2.5 minutes v s. 36.4 +/- 2.8 minutes). No difference in the incidence of complicati ons during emergence and recovery was found. Evaluation of recovery as assessed by a modified Aldrete score showed that children who had rec eived sevoflurane reached higher scores in the first 30 minutes follow ing the discontinuation of the anesthetic. The Pain/Discomfort Scale d emonstrated a difference in the sevoflurane group, with more children being agitated and restless. Conclusion: Sevoflurane provides a safe a nd rapid anesthetic induction with no differences in complications dur ing the induction, maintenance, and emergence period. With sevoflurane , the time of emergence and recovery was significantly shorter. The ch aracteristics of sevoflurane as evaluated in the present study make it a suitable anesthetic in pediatric outpatient surgery even in the pre sence of mile URI.