Sevoflurane versus propofol for induction and maintenance of anaesthesia with the laryngeal mask airway in children

We compared patient outcomes for propofol vs sevoflurane with the laryngeal mask airway (LMA) using either spontaneous breathing (SB) or pressure cont rolled ventilation (PCV). One hundred and twenty children undergoing minor surgery below the umbilicus were randomly assigned to receive either (1) pr opofol 3 mg.kg(-1) followed by a maintenance infusion of 5 mg.kg(-1).h(-1), or (2) induction with sevoflurane 7% followed by maintenance with 1.7%. Fo llowing LMA insertion, patients were given atracurium and underwent PCV if surgery was expected to last greater than or equal to 30 min. The following assessments were made: time to LMA insertion/removal, airway problems, car diorespiratory effects and recovery characteristics. The first time inserti on success rates were similar, but insertion time was shorter with sevoflur ane (115 +/- 67 s vs 252 +/- 107 s, P < 0.0001). One patient coughed during placement, but there were no other problems during any phase of anaesthesi a in any group. Heart rate was higher in the sevoflurane group following in sertion, during maintenance and emergence tall P < 0.03). There were no dif ferences in blood pressure and oxygen saturation among groups PECO2 in the SE group was unaffected by the agent used. Emergence was more rapid (232 +/ - 104 s vs 348 +/- 127 s, P < 0.0001) and postoperative agitation more comm on (15% vs 0%, P = 0.02) with sevoflurane. There were no differences in the Aldrete scores among groups. Patient outcome was similar for the SE and PC V groups. We concluded that the techniques described here using propofol an d sevoflurane are equally suitable for induction and maintenance of anaesth esia with the LMA in children undergoing minor surgery below the umbilicus. Emergence is more rapid, but postoperative agitation more common with sevo flurane.