Recovery after halothane anaesthesia induced with thiopental, propofol-alfentanil or halothane for day-case adenoidectomy in small children

We studied recovery from halothane anaesthesia in 93 children, aged 1-3 yr, undergoing daycase adenoidectomy. Children were allocated randomly to rece ive thiopental 5 mg kg(-1) (group TH), alfentanil 10 mu g kg(-1) and propof ol 3 mg kg(-1) (group PAH) or 5% halothane (group HH) for induction of anae sthesia. In group TH, tracheal intubation was facilitated with succinylchol ine (suxamethonium) 1.5 mg kg(-1). In groups PAH and HH, tracheal intubatio n was performed without neuromuscular block, and succinylcholine was used o nly if required. Anaesthesia was maintained with 1-3% halothane during spon taneous respiration. Times to achieving predetermined recovery end-points w ere recorded. Quality of recovery was assessed using a score of 1-9 (best t o worst) for sedation, crying, restlessness and agitation. A postoperative questionnaire was used to determine the well-being of the child at home, 24 h after operation. Emergence from anaesthesia (response to nonpainful stim uli) occurred earlier in group HH (mean 9 (SD 6) min) than in groups PAH (1 3 (6) min, P<0.01) and TH (18(14) min, P<0.01). Sitting up, walking and hom e readiness were achieved earlier in groups PAH and HH than in group TH (P< 0.05 for each variable). Children in group TH were more sedated during the first 30 min after anaesthesia than those in the two other groups (P<0.05) while emergence-related delirium was more common in group HH than in group TH (P<0.01). Well-being at home was similar in all groups. We conclude that induction of halothane anaesthesia with propofol-alfentanil or halothane p rovided more rapid recovery and earlier discharge than that with thiopental .