A randomized multicenter study of remifentanil compared with halothane in neonates and infants undergoing pyloromyotomy. I. Emergence and recovery profiles

Pyloric stenosis is sometimes associated with hemodynamic instability and p ostoperative apnea. In this multicenter study we examined the hemodynamic r esponse and recovery profile of remifentanil and compared it with that of h alothane in infants undergoing pyloromyotomy. After atropine, propofol, and succinylcholine administration and tracheal intubation, patients were rand omized (2:1 ratio) to receive either remifentanil with nitrous oxide and ox ygen or halothane with nitrous oxide and oxy en as the maintenance anesthet ic. Pre- and postoperative pneumograms were done and evaluated by an observ er blinded to the study. Intraoperative hemodynamic data and postanesthesia care unit (PACU) discharge times, PACU recovery scores, pain medications, and adverse events (vomiting, bradycardia, dysrhythmia, and hypoxemia) were recorded by the study's research nurse. There were no significant differen ces in patient age or weight between the two groups. There were no signific ant differences in hemodynamic values between the two groups at the various intraoperative stress points. The extubation times, PACU discharge times, pain medications, and adverse events were similar for both groups. No patie nt anesthetized with remifentanil who had a normal preoperative pneumogram had an abnormal postoperative pneumogram, whereas three patients with a nor mal preoperative pneumogram who were anesthetized