Propofol/remifentanil versus sevoflurane/remifentanil in paediatric anaesthesia

Introduction. The aim of this study was to compare total intravenous anaest hesia (TIVA) using propofol and remifentanil (P/R-group) and balanced anaes thesia (BA) using sevoflurane and remifentanil (S/R-group) for paediatric s urgery. Patients and methods. A total of 120 patients aged 6 months to 16 y ears scheduled for elective minor lower abdominal surgery were randomly ass igned to receive either propofol (5-10 mg/kg/h) and remifentanil (0.125-1.0 mug/kg/min) or sevoflurane (1.0-1.5 MAC) and remifentanil (0.125-1.0 mug/k g/min). Perioperative haemodynamics as well as recovery and discharge times , PONV and side-effects were studied. The patients vigilance, comfort and p ain intensity were assessed postoperatively using the objective pain discom fort scale, the Steward post-anaesthetic recovery score and a visual analog ue scale. Results. Postoperative recovery (9.0 vs 11.6 min) and extubation times (11.8 vs. 15.0 min) as well as the time taken until a Steward post-an aesthetic recovery score >3/4 (15.2 vs.21.4 min) was reached were significa ntly shorter in the P/R-group. However, the length of time until discharge to the ward, postoperative comfort, pain intensity and analgesic requiremen ts as well as PONV were comparable in both groups. Conclusions. With regard s to the investigated parameters,TIVA with propofol and remifentanil is equ ally effective as BA with sevoflurane and remifentanil in paediatric patien ts. However, considering the selected dosing regimen, recovery times were s ignificantly shorter for children after TIVA.