COMPARISON OF TOTAL INTRAVENOUS ANESTHESIA WITH INHALER ANESTHESIA IN CHILDREN INTUBATED WITH REMIFENTANIL WITHOUT MUSCLE RELAXANT

Abstract

ABSTRACT Introduction: The anaesthesia protocol we choose for tonsillectomy and adenoidectomy operations in pediatric patients should be able to provide adequate depth rapidly while allowing comfortable and high-quality tracheal intubation, and recovery from anaesthesia should be rapid and uneventful. In this study, we aimed to compare the effects of total intravenous and inhaler anaesthesia on intubation quality, spontaneous breathing, extubation, eye-opening time, hemodynamic parameters, pain, recovery and agitation scores in children undergoing intubation without muscle relaxant with remifentanil. Materials and Methods: This study was performed on 80 patients. Patients were randomly divided into two groups. In group TIVA, 2.5 mg/kg propofol and two mcg/kg remifentanil were administered as induction within 90 seconds, and 3 mg/kg/hour propofol and 0.5 mcg/kg/min remifentanil were used for maintenance of anaesthesia. In Group Sevoflurane, 8% sevoflurane and two mcg/kg remifentanil were administered as induction within 90 seconds, and 2.5% sevoflurane, 50% nitrogen protoxide and 50% oxygen were used at 6lt/min for the maintenance of anaesthesia. Findings: There was no significant difference between the groups regarding intubation scoring. Peak Heart Rate and Systolic Arterial Pressure were significantly higher in Group 2. Diastolic Arterial Pressure was higher in Group 1 at 1 and 2 minutes and in Group 2 at 10 minutes postoperatively. Mean Arterial Pressure was higher in Group 1 at 2 minutes after intubation and 20 minutes postoperatively. Wong-Baker pain scale and agitation score were significantly higher in Group 2. Spontaneous respiration and extubation time were significantly shorter in Group 2. There was no difference between the groups in terms of side effects Conclusion: Successful intubation was achieved in both groups, and it was concluded that Group TIVA would be a better choice in children in terms of postoperative pain, agitation and recovery.