Abstract
Objective : To compare effectiveness of inhalation sevoflurane and intravenous (IV) propofol anaesthesia with the laryngeal mask airway (LMA) in children undergoing surgeries below umbilicus. Method : Sixty premedicated children 3-12 years old with the American Society of Anaesthesiologists physical status of I to II were enrolled and received either induction with sevoflurane 7% by face mask and maintained with a 50% oxygen and 50% nitrous oxide mixture followed by 1.7% sevoflurane or induction with 3 mg/kg propofol IV followed by infusion of 170µg/kg/min with LMA. Demographic data, induction time, number of attempts, LMA insertion, removal and recovery times, haemodynamic parameters, complications, Aldrete score and child’s behaviour score were recorded. Results: Demographic data and induction time were similar for the 2 treatment groups. LMA insertion was successful at the first attempt in 93% with sevoflurane and 83% with propofol. LMA insertion, removal and recovery times were significantly longer in the propofol group (1.56±0.22, 5.89±1.23, 12.3±3.09 minutes respectively) than in the sevoflurane group (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively) (P Conclusions: Sevoflurane provided shorter LMA insertion, removal and recovery times than IV propofol in children undergoing minor surgeries below umbilicus with comparable perioperative complications. Agitation was significantly more with sevoflurane. Sri Lanka Journal of Child Health , 2014; 43 (2): 77-83 (Key words: Sevoflurane; laryngeal mask airway; propofol; paediatric) DOI: http://dx.doi.org/10.4038/sljch.v43i2.7004
Highlights
In paediatric anaesthesia laryngeal mask airway (LMA) has gained widespread acceptance as it provides an effective bridge between face mask and endotracheal tube, thereby providing effective ventilation[1]
Demographic data, duration of surgery and anaesthesia, type of surgery and induction time performed were similar for the two treatment groups
The LMA insertion, removal and recovery times were significantly longer in the propofol group (1.56± 0.22, 5.89±1.23, 12.3±3.09 minutes respectively) than in the sevoflurane group (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively) (P
Summary
In paediatric anaesthesia laryngeal mask airway (LMA) has gained widespread acceptance as it provides an effective bridge between face mask and endotracheal tube, thereby providing effective (spontaneous or controlled) ventilation[1] It is a simple, well tolerated, safe, reusable, cost effective method for airway management in both neonatal and paediatric patients[2,3]. Ability to induce and maintain anaesthesia with one drug, better conditions for LMA insertion, an ability to induce anaesthesia without IV access, thereby facilitating patient turnover in busy ambulatory settings are other advantages[9,10] It has disadvantages such as more frequent incidence of postoperative nausea and vomiting, agitation and increased pollution of the operating room with anaesthetics when compared with IV propofol[11]
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