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Propofol as a sole agent for paediatric day care diagnostic ophthalmic procedures: comparison with halothane anaesthesia
Author(s) -
Madan Rashmi,
Kapoor Indu,
Balachander S.,
Kathirvel S.,
Kaul H. L.
Publication year - 2001
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.1460-9592.2001.00741.x
Subject(s) - medicine , propofol , anesthesia , sedation , halothane , general anaesthesia , bolus (digestion) , surgery
Background : Our aim was to study the feasibility of total intravenous anaesthesia with propofol in spontaneously breathing children undergoing ophthalmic procedures. Methods : Fifty‐five children (aged 6 months to 5 years) were randomly allocated to receive either propofol bolus (until loss of eyelash reflex) followed by infusion [group P ( n =29)] or halothane 3–4% for induction, followed by 1–2% in 70% nitrous oxide and oxygen via face mask [group H ( n =28)]. Dose for induction and maintenance, intraoperative adverse events, time to recovery (on an Observer’s Assessment of Alertness/Sedation Scale, 5 at each level) and duration of procedure were recorded. All children in both groups, were anaesthetized successfully. Results : 4.0 ± 0.7 mg·kg –1 and 5.1 ± 1.0 mg·kg –1 of propofol were required for loss of eyelash reflex and tolerance of the ophthalmic speculum, respectively. An infusion rate of 8.3 ± 1.7 mg·kg –1 ·h –1 was needed for maintenance of anaesthesia; 3.4 ± 0.5%, 3.6 ± 0.4% and 1.4 ± 0.4% halothane was needed for induction, tolerance of the eye speculum and maintenance of anaesthesia, respectively. Induction and recovery were significantly faster with halothane compared with propofol [induction – 38.3 ± 6.6 s (group H)/60.9 ± 15.2 s (group P) ( P < 0.001); recovery 12.8 ± 4.6 min (group H)/27.0 ± 23.3 min (group P) ( P < 0.001)]. Apnoea, coughing and breath‐holding were seen only in group H. Group P had significantly higher incidence of involuntary movements (minor degree) ( n =6) ( P < 0.01). Conclusions : Propofol is a feasible option for paediatric diagnostic ophthalmic procedures with the advantage over halothane of providing complete access to the eye.