Sevoflurane causes more postoperative agitation in children than does halothane

Background: An agitated recovery may occur after inhalation anesthesia. The aim of the present study was to assess the recovery quality after mask ane sthesia with either halothane or sevoflurane in children. Methods: Sixty-two Children, 8 months to 18 years of age, scheduled for min or surgery, were randomly assigned to receive either halothane or sevoflura ne. The patients were premedicated with midazolam and anesthesia was induce d iv with propofol or by inhalation and maintained with halothane or sevofl urane in N2O/O-2 via face mask. Recovery was assessed by a "blinded" observ er using a postanesthetic recovery score. Agitation and pain were judged us ing a visual analog scale. The incidence of vomiting was noted. The day aft er anesthesia older children and parents of younger children were interview ed about their experience of the anesthesia and recovery period. Results: There were no differences between groups in respect of age, weight , length, or duration of surgery or inhalational. gas exposure. Median time from end of administration of inhalational agent to spontaneous eye openin g was less after sevoflurane (25 min) than after halothane (48 min), (P<0.0 1). Likewise, recovery was faster after sevoflurane anesthesia (P<0.05). Ag itation, but not pain, occurred more frequently after sevoflurane than afte r halothane (P<0.05) and agitation was significantly more common in younger children. There was no difference in duration of hospital stay between day -care patients in the two groups. Conclusion: Early postanesthetic agitation and recovery was faster after ma sk anesthesia with sevoflurane than after halothane. There was a higher inc idence of agitation in younger children, without correlation to pain.