Recovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringotomy and pressure equalization tube insertion

This double-blinded study was undertaken to prospectively evaluate the role of halothane and sevoflurane and the use of IV ketorolac on the anesthetic emergence in a group of children undergoing bilateral myringotomy with pre ssure equalization tube procedures. Two-hundred ASA. physical status I and II patients were premedicated with nasal midazolam (0.2 mg/kg) and randomiz ed to one of four groups (Group 1 - halothane and ketorolac; Group 2 - halo thane and placebo; Group 3 - sevoflurane and ketorolac; Group 4 - sevoflura ne and placebo). A blinded nurse observer characterized the quality of the anesthetic emergence and recorded the incidence of emesis and the use of pa in medications in the recovery room. There were no differences in age, weig ht, previous anesthetic experience, or duration of anesthesia among the fou r groups. There was no difference in the incidence of emergence agitation f or patients anesthetized with sevoflurane compared with halothane, regardle ss of whether they received ketorolac or placebo. Regardless of the anesthe tic, the incidence of emergence agitation was significantly less in patient s who received ketorolac compared with patients who received placebo. The i ncidence of emesis in the recovery room, the total 24-h incidence of emesis , and the use of at-home pain medications were similar in all four groups. Implications: We conclude that the incidence of emergence agitation in chil dren undergoing ultrashort anesthetic procedures is similar for sevoflurane and halothane and that ketorolac markedly diminishes emergence agitation a nd/or pain behavior.