Propofol as a sole agent for paediatric day care diagnostic ophthalmic procedures: comparison with halothane anaesthesia

Background: Our aim was to study the feasibility of total intravenous anaes thesia with propofol in spontaneously breathing children undergoing ophthal mic procedures. Methods: Fifty-five children (aged 6 months to 5 years) were randomly alloc ated to receive either propofol bolus (until loss of eyelash reflex) follow ed by infusion [group P (n=29)] or halothane 3-4% for induction, followed b y 1-2% in 70% nitrous oxide and oxygen via face mask [group H (n=28)]. Dose for induction and maintenance, intraoperative adverse events, time to reco very (on an Observer's Assessment of Alertness/Sedation Scale, 5 at each le vel) and duration of procedure were recorded. All children in both groups, were anaesthetized successfully. Results: 4.0 +/- 0.7 mg.kg(-1) and 5.1 +/- 1.0 mg.kg(-1) of propofol were r equired for loss of eyelash reflex and tolerance of the ophthalmic speculum , respectively. An infusion rate of 8.3 +/- 1.7 mg.kg(-1).h(-1) was needed for maintenance of anaesthesia; 3.4 +/- 0.5%, 3.6 +/- 0.4% and 1.4 +/- 0.4% halothane was needed for induction, tolerance of the eye speculum and main tenance of anaesthesia, respectively. Induction and recovery were significa ntly faster with halothane compared with propofol [induction - 38.3 +/- 6.6 s (group H)/60.9 +/- 15.2 s (group P) (P < 0.001); recovery 12.8 +/- 4.6 m in (group H)/27.0 +/- 23.3 min (group P) (P < 0.001)]. Apnoea, coughing and breath-holding were seen only in group H. Group P had significantly higher incidence of involuntary movements (minor degree) (n=6) (P < 0.01). Conclusions: Propofol is a feasible option for paediatric diagnostic ophtha lmic procedures with the advantage over halothane of providing complete acc ess to the eye.