Recovery after propofol infusion anaesthesia in children: comparision with propofol, thiopentone or halothane induction followed by halothane maintenance

Abstract

We have compared the recovery profiles of 163 healthy Chinese children after general anaesthesia for minor surgical procedures. Patients were allocated randomly to receive one of four anaesthetic techniques: propofol infusion for induction and maintenance using a pharmacokinetic model-controlled syringe pump set initially at a target concentration of 8 micrograms ml-1 and then adjusted according to clinical requirements; propofol 2.5-3.5 mg kg-1, thiopentone 4-5 mg kg-1 or 2-3% halothane for induction of anaesthesia followed by 1-2% halothane for maintenance of anaesthesia. All patients breathed a mixture of 70% nitrous oxide in oxygen through a laryngeal mask airway and received an appropriate regional anaesthetic block. Recovery was assessed using the time to achieve full Steward score, open eyes on command, orientation and the time required to complete a simple puzzle. Recovery was slowest with the propofol infusion (mean 39.8 (SD 12.9) min when eyes opened on command). The recovery times were significantly shorter with the three other techniques (propofol bolus 21.9 (9.9) min, thiopentone 23.4 (11.3) min, halothane 20.1 (8.9) min), and the choice among these three methods had no significant influence on the recovery profile.

Propofol as a sole agent for paediatric day care diagnostic ophthalmic procedures: comparison with halothane anaesthesia

“…The short duration of anaesthesia in our study (< 8.5 min), as also seen in the other studies (16,29,30) (< 30 min), allowed propofol to have a residual effect in the early postoperative period, thus explaining the significantly slower recovery in group P compared with group H. The short duration of anaesthesia in our study may have also resulted in failure of several tissues to reach equilibrium with the alveolar halothane partial pressure. This would result in a more rapid elimination of halothane after discontinuation (30).…”

“…In contrast, in a study by Aun et al . (29), the group receiving propofol for induction and maintenance had the slowest recovery when compared with propofol with halothane or only halothane anaesthesia.…”

Recovery of psychomotor function following general anaesthesia in children: a comparison of propofol and thiopentone/halothane

“…The propofol induction dose of 2.5 mg.kg-' was in accordance with other studies (11,(17)(18)(19). Some investigators have chosen higher induction doses but in patients of considerable younger average age.…”

Dosage scheme for propofol in children under 3 years of age

“…The total propofol per time unit, as well as time to awakening were registered and used as criteria to adjust the dosage scheme. The patients were considered awake after the procedure, if they opened their eyes spontaneously or reacted to verbal‐ or tactile‐contact and had regained their reflexes (9,10).…”

“…Propofol for TIVA and for deep intravenous sedation during surgery under regional anaesthesia had been used in our clinic in children over 3 years of age since 1988. As TIVA has certain anaesthetic advantages, such as controllability, cost‐effectiveness and absence of air pollution (9), we started using propofol in younger children in 1990.…”