Clinical comparison of sevoflurane and propofol anesthesia with propofol and remifentanil anesthesia for children with cleft lip and palate repair surgery

Abstract

To compare the clinical efficacies and safety of sevoflurane and propofol versus remifentanil and propofol anesthesia for children with cleft lip and palate repair surgery. Upon the approval of hospital ethical committee,a total of 60 pediatric patients undergoing cleft lip and palate repair surgery were recruited from two hospitals between April 2011 and December 2012. All patients were randomly divided into 2 groups (n = 30 each). Group S:sevoflurane and propofol anesthesia; and group R: propofol and remifentanil anesthesia.Heart rate (HR), mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) were recorded at the time before the induction (T0), after 2 min of induction (T1), the beginning of surgery (T2) and the end of surgery (T3).Intubating satisfaction, time to extubation,incidence of emergence agitation, postoperative nausea and vomiting, and the complications of the airway were recorded. Satisfactory intubation rate was 90% in group S, versus 83% in group R. And there was no significantly difference between the two group. There were no significantly difference between the two group with MAP and HR.Compared with T0, There were significantly difference with MAP and HR at T1, T2 in group R (P < 0.05). The incidence of emergence agitation was significantly higher in group S (7 cases) than that in group R (2 cases).there were no records of nausea, vomiting and laryngospasm. Under an adequate depth anesthesia, these two anesthesia techniques are safe for cleft lip and palate repair surgery, emergence agitation was high in sevoflurane anesthesia, propofol and remifentanil anesthesia provides lower heart rate.