ANESTHESIA FOR PEDIATRIC HERNIORRHAPHY OR HYDROCELECTOMY - COMPARISONOF PROPOFOL KETAMINE AND THIOPENTONE/HALOTHANE/

Total intravenous anesthesia has recently become available for ambulat ory surgery. It has the advantages of decreased air contamination from volatile anesthetics and decreased exposure of operating room personn el to volatile anesthetics. The purpose of this study was to compare t he anesthetic properties of propofol/ketamine (total intravenous) anes thesia and thiopentone/halothane (intravenous and gaseous) anesthesia for herniorrhaphy or hydrocelectomy in children. Sixty children aged 2 to 7 years scheduled for herniorrhaphy or hydrocelectomy were allocat ed to two groups. The propofol/ketamine group (group 1) received a. lo ading dose of intravenous propofol 3 mg/kg followed by propofol infusi on 200 mu g/kg/minute; additional bolus doses of propofol 1 mg/kg were given as needed or the infusion dose was increased or decreased by 33 mu g/kg/minute as needed. Ketamine 1 mg/kg was administered intraveno usly 2 to 3 minutes before herniorrhaphy or hydrocelectomy to reinforc e the analgesic and anesthetic effects of propofol. The thiopentone/ha lothane group (group 2) received intravenous thiopentone 6 mg/kg follo wed by halothane with 40% oxygen using a mask. Group 2 patients mainta ined spontaneous breathing with intermittent assistance and group 1 pa tients maintained spontaneous natural airway breathing during anesthes ia. The scores on the postoperative assessment scale were higher in gr oup 2 patients, indicating poorer anesthesia recovery characteristics, but the differences were not significant. Pain on injection was more frequent in group 1 (12/32) than in group 2 (2/28). The incidence of v omiting in group 2 (6/28) was significantly higher than in group (0/32 ). We conclude that propofol/ketamine allows patients to maintain spon taneous natural airway breathing during anesthesia, and its analgesic and anesthetic effects are comparable to those of thiopentone/halothan e. Propofol/ketamine is appropriate for pediatric herniorrhaphy and hy drocelectomy. It can be recommended for pediatric ambulatory surgery.