PROPOFOL ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS - A COMPARISON WITH THIOPENTONE AND HALOTHANE

The purpose of this study was to evaluate the haemodynamic changes dur ing induction, as well as the speed and quality of recovery when propo fol (vs thiopentone and/or halothane) was used for induction and maint enance of anaesthesia in paediatric outpatients. One hundred unmedicat ed children, 3-12-yr-old, scheduled for ambulatory surgery were studie d. The most common surgical procedures performed were eye muscle surge ry (42%), plastic surgery (21%), dental restoration (15%), and urologi cal procedures (15%). The children were randomized to an anaesthetic r egimen for induction/maintenance as follows: propofol/propofol infusio n; propofol/halothane; thiopentone/halothane; halothane for both induc tion and maintenance. Succinylcholine 1.5 mg.kg(-l) was used to facili tate tracheal intubation and N2O/O-2 were used as the carrier gases in each case. All maintenance drugs were titrated according to the clini cal response of the patient to prevent movement and/or maintain BP +/- 20% of baseline. Two patients (4%) who received propofol expressed di scomfort during injection. The mean propofol dose required to prevent movement was 267 +/- 83 mu g.kg(-1).min(-1). The overall pattern of ha emodynamic changes, as well as awakening (extubation) times were not d ifferent among the four groups. Children who received propofol recover ed faster (22 vs 29-36 min) (P < 0.05), were discharged home sooner (1 01 vs 127-144 min) (P < 0.05), and had less postoperative vomiting (4 vs 24-48%) (P < 0.05) than all others. There were no serious complicat ions or adverse postoperative sequelae in any of the patients in the s tudy It is concluded that induction and maintenance of anaesthesia wit h propofol is a well-tolerated anaesthetic technique in children, and is associated with faster recovery and discharged as well as less vomi ting than when halothane is used.