Total Intravenous Anesthesia In Tonsillectomy

Abstract

Back ground &Objective: Total intravenous anesthesia in pediatric tonsillectomy, decreases the incidence of frequently occurred complications, and induce nice quick recovery.we investigate the efficacy and safety of total intravenous anesthesia with remifentanyl and propofol in this operations,so the safety of remifentanil in spontaneous ventilation.

 Materials and Methods: In randomized clinical trial, (35) pediatric patient(24M/11F),(6±3)old age, ASA class Ⅰ-Ⅱ, scheduled for elective tonsillectomy were allocated to receive sevoflouran 3MAC(S  group, n=18) or remifentanyl 1 μg·kg-1+propofol 2mg.kg-1 (R  group, n=17). After induction of anesthesia, R group received continuous infusion of remifentanil and propofol, and S group received inhaled sevoflurane 1,5MAC, with N2o/O2. Heart rate (HR),EtCo2,respiratory rate,Spo2 were measured after induction (in 5 minutes intervals).Spontaneous breathing, recovery time, extubation time, the intubation scores, evaluation of the pediatric anesthesia emergence delirium scale and Aldrete scores  were recorded.we used T-test for statistical analysis when P<0.05.

 Results: There were no significant differences in intubating scores, Aldrete scores, recovery time,   extubation time. While other results refers to the efficacy and safety of remifentanil, that the spontaneous breathing occurs within 5 minutes(P<0.001), Et CO2 values were alike.Delirium scores were better in R group(1.23±0.56) while S group(3.5±1.29),P<0.001.

Conclusion: We found that Total intravenous anesthesia with remifentanil and propofol in pediatric tonsillectomy can maintain spontaneous breathing, perioperative hemodynamic stability and induce quick recovery .