Sevoflurane versus propofol in the induction and maintenance of anaesthesia in children with laryngeal mask airway

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<0.0001). Perioperative minor complications were comparable. Recovery milestones including Aldrete score were significantly higher in group S (9.03) than in group P (7.8) at 5 minutes (P<0.05) and comparable at 15 and 30 minutes. There was a greater incidence of excitatory phenomena with sevoflurane compared with propofol which was statistically significant (P<0.05). Haemodynamics were comparable in both groups. 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.