Comparison of sevoflurane and propofol's effects on hemodynamics and recovery in mentally retarded pediatric patients undergoing outpatient dental surgery

Abstract

Objective: We aimed to compare the effects of sevoflurane and propofol on hemodynamics and recovery variables in mentally retarded patients undergoing day-case dental treatment under general anesthesia. Material and Methods: Fifty mentally retarded pediatric patients (8-18 years) undergoing day case dental treatment were included in the study after approval of the Faculty Ethics Committee. The patients were randomized into two groups: Propofol group (PG) (n=25) and sevoflurane group (SG) (n=25). Anesthesia induction was performed with 1-8% sevoflurane and 50% N2O/O2 mixture. Once unconsciousness was achieved after induction, an intravenous cannula was placed, and 10 μg kg-1 atropine, 1 μg kg-1 fentanyl and, 0.1 mg kg-1 vecuronium were administered. Subsequent to endotracheal intubation, anesthesia was maintained with propofol 9 mg kg-1 hr-1 in first 10 minutes, 6 mg kg-1 hr-1 between 10 and 20 minutes and 4-6 mg kg-1hr-1 after 20 minutes in the PG. In SG, anesthesia was maintained with a mixture of 50 % N2O/O2 and 2% end-tidal sevoflurane. The times to spontaneous breathing, extubation, response to verbal commands, modified Aldrete score ≥9 (MAS≥9) and postoperative side effects were recorded. Results: There were no statistical differences between groups for hemodynamic variables (p>0.05). The time to MAS≥9 was significantly shorter with propofol (p=0.048), when compared with sevoflurane, while other recovery parameters were similar between the groups. Conclusion: In general anesthesia of mentally retarded patients undergoing outpatient dental treatment, propofol provided faster postoperative recovery of the Modified Aldrete Score when compared to sevoflurane, however both agents were safe and effective in providing anesthesia in this patient population. © 2014 by Türkiye Klinikleri.