comparing of recovery after total Intravenous (TIVA) and Sevoflurane anesthesia in 2 to 10-year children

Abstract

Sevoflurane is an attractive anesthetic in pediatric outpatient surgery because of nonpungent and rapid increases in alveolar anesthetic concentrations, low blood and tissue solubility. On the other hand, Total Intravenous Anesthesia (TIVA) is very popular because of its rapid recovery with absence of postoperative side effect. The present study was designed to compare inhalation anesthesia with sevoflurane and total intravenous anesthesia (TIVA) with propofol infusion as it relates to the quality of recovery including postoperative pain, postoperative nausea and vomiting, and hemodynamic status, Duration of PACU stay in pediatric outpatient surgery in order to use the best anesthesia technique for children. Methods: Children aged 2 to 10 years old undergoing outpatient surgery were randomly assigned to one of two groups of total intravenous anesthesia receiving propofol (n = 40, induction with 3–5 mg / kg, maintenance with 250 to 100 μg / kg.min), and the inhalation group receiving sevoflurane (n = 40, induction with 8 vol.%, maintenance with 2–3vol.%). Demographic characteristics, awakening quality in recovery, hemodynamic status, and other complications such as patient agitation, pain, nausea, and vomiting were evaluated in both groups. Results: Patients did not differ significantly in terms of demographic characteristics. Incidence of postoperative agitation was 62% higher in the sevoflurane group than the propofol group with 5% (p <0.001). The highest percentage of pain was obtained as 52.5% in the sevoflurane group. Postoperative nausea and vomiting were similar in both groups, and there was a significant decrease in the heart rate of the subjects in the (TIVA) group as one of hemodynamic variables (P = 0.01).