Maintenance and recovery characteristics after sevoflurane or propofol during ambulatory surgery in children with epidural blockade

Purpose: To compare the maintenance and recovery characteristics after sevo flurane with those after propofol in children with epidural blockade. Methods: Fifty unpremedicated, children ASA I-II, 2 - 8 yr of age, schedule d for elective urological surgery as out-patients, were randomly allocated to receive either: I) sevoflurane for induction and maintenance of anaesthe sia or 2) propofol for induction (2-3 mg.kg(-1) iv) and for maintenance (5- 10 mg.kg(-1).hr(-1) iv). All children received N2O 70% in oxygen before ind uction and throughout the anaesthetic, rocuronium for neuromuscular blockad e and a lumbar or caudal epidural block before incision. Heart rate (HR), s ystolic blood pressure (SBP), recovery times and ail side effects during ma intenance and recovery were recorded by a blinded observer. Adverse events during the first 24 hr were also recorded. Results: Mean HR increased 5-10% after induction in both groups reaching a maximum by five minutes. Heart rate returned to baseline by skin incision i n the sevoflurane group and by IO min after induction in the propofol group . During maintenance, HR decreased by 10-20% below baseline values by 20 mi n in the propofol group only. where it remained for the remainder of the an aesthetic. Similarly SEP increased by 10% after induction of anaesthesia in both groups, but returned to baseline by 10 min. Light anaesthesia occurre d in four (16%) children, all in the propofol group. Emergence and recovery indices were similar in the two groups. Discussion: Sevoflurane and propofol exhibit similar maintenance and recove ry profiles when combined with epidural analgesia in children undergoing am bulatory surgery.