Comparison of Remifentanil-Propofol and Remifentanil-Sevoflurane Anesthesia for Pediatric Tonsillectomy

Chung, Chan Jong; Lee, Jung Moo; Choi, So Rhon; Chin, Young Jhoon

Clinical Research

Pediatric Anesthesia

Anesthesia and Pain Medicine 2006;1(1):56-60.
Published online July 30, 2006.

Comparison of Remifentanil-Propofol and Remifentanil-Sevoflurane Anesthesia for Pediatric Tonsillectomy

Chan Jong Chung, Jung Moo Lee, So Rhon Choi, Young Jhoon Chin

Department of Anesthesiology and Pain Medicine, College of Medicine, Dong-A University, Busan, Korea. cjchung@dau.ac.kr

Abstract

BACKGROUND
This study compared the hemodynamic response and recovery profile of remifentanil-sevoflurane anesthesia for a pediatric tonsillectomy with that of remifentanil-propofol anesthesia. METHODS: Fifty healthy children (4-10 yr) undergoing a tonsillectomy were randomly assigned to one of two groups. Anesthesia was induced with remifentanil 1 mcg/kg over 1 min, propofol 2 mg/kg, and rocuronium 0.8 mg/kg. Anesthesia was maintained with remifentanil 0.25 mcg/kg/min and propofol 6 mg/kg/h, or remifentanil 0.25 mcg/kg/min and sevoflurane 1.0 vol%. The propofol and sevoflurane dose was kept unchanged, and remifentanil was titrated according to the hemodynamic response. The perioperative hemodynamics, recovery time, and side effects were assessed. RESULTS: Remifentanil-based anesthesia with propofol or sevoflurane resulted in stable hemodynamics, but sevoflurane was associated with a significantly lower systolic blood pressure. The recovery times were similar for spontaneous ventilation, extubation, eye opening, orientation, and full recovery in both groups. The incidence of side effects was similar in both groups. CONCLUSIONS: Remifentanil/sevoflurane is as equally effective as remifentanil/propofol in pediatric patients. The hemodynamic stability is appropriate and the recovery from anesthesia is rapid.

Key Words: pediatric anesthesia, remifentanil, tonsillectomy