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Evaluation of awakening and recovery characteristics following anaesthesia with nitrous oxide and halothane fentanyl or both for brief outpatient procedures in infants
Author(s) -
ROETMAN KAREN,
WELBORN LEILA,
HANNALLAH RAAFAT,
FINK ROBERT,
NORDEN JANET,
O’DONNELL REGINA
Publication year - 1997
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.1997.d01-108.x
Subject(s) - medicine , fentanyl , anesthesia , halothane , bradycardia , ventilation (architecture) , tracheal intubation , inhalation , intubation , atropine , general anaesthesia , isoflurane , surgery , heart rate , blood pressure , mechanical engineering , engineering
This study compared recovery characteristics and postoperative ventilatory function when halothane, fentanyl or combination of halothane and fentanyl in addition to N 2 O were used for intraoperative anaesthesia in term infants undergoing hernia repair as outpatients. Sixty‐six full term ASA PS I infants ages 1–12 months were studied. All received inhalation induction with N 2 O, O 2 and halothane, followed by intravenous atropine and atracurium, tracheal intubation, and controlled ventilation. For anaesthesia maintenance, patients were randomized into one of three groups. Group I received 70% N 2 O, 30% O 2 and halothane. Group II received 70% N 2 O, 30% O 2 , halothane and 2 μg·kg −1 fentanyl. Group III received 70% N 2 O, 30% O 2 and 10 μg·kg −1 fentanyl. Awakening times were similar in all three groups, however, Group I patients had significantly shorter recovery and discharge times than those of Group II and III. None of the patients experienced postoperative apnoea or periodic breathing. One patient in Group III experienced two brief episodes of bradycardia not associated with apnoea or arterial desaturation ( S p o 2 >90% for greater than 30 s). Decreased S p o 2 occurred less frequently in Group I (5.9%) compared to Group II (22.7%) and Group III (19.0%) patients, however, the group differences were not significant. Transcutaneous CO 2 (TcCO 2 ) values were not statistically different among the three groups. Pain scores were initially lower in Groups II and III, but at 120 min the differences were not significant. Postoperative apnoea was not observed in this study. S p o 2 <90% and TcCO 2 >9 kPa (70 mmHg) was more common in infants receiving 2 and 10 μg·kg −1 fentanyl than in infants receiving halothane and nitrous oxide anaesthesia. Infants <3 months old did not have a higher incidence of S p o 2 <90% or significantly higher TcCO 2 values when compared to infants >3 months old. Fentanyl in doses used in this study did not prolong awakening time but did prolong recovery and discharge times in outpatient infants.