Comparison of Sevoflurane With Laryngeal Mask Airway Versus Propofol Infusion With Facemask for Eye Examination Under Anesthesia in Children: A Randomized Controlled Trial

Purpose: To compare sevoflurane with laryngeal mask airway (LMA) and propofol infusion with an oxygen facemask in children undergoing ophthalmic examinations under anesthesia (EUA) regarding time to operating room discharge. Methods: In this prospective, randomized, single-blind study, children aged 1 to 6 years undergoing EUA were assigned to sevoflurane with LMA (the sevoflurane group) or propofol with oxygen facemask (the propofol group). The primary outcome was operating room discharge time. Secondary outcomes included induction time, nonoperative time, total anesthesia time, surgery duration, post-anesthesia care unit stay, ophthalmologist satisfaction, respiratory adverse events/interventions, EUA interruptions, wake-up time, emergence agitation, postoperative nausea and vomiting, and pain medication use. Results: Sixty patients were enrolled. Operating room discharge time was significantly shorter in the propofol group than the sevoflurane group (7.17 ± 3.11 vs 9.81 ± 4.38 minutes, 95% CI: 0.67 to 4.60, P = .009). Induction time (8.63 ± 4.37 vs 11.93 ± 6.26 minutes, 95% CI: 0.48 to 5.99, P = .022) and nonoperative time (15.80 ± 5.57 vs 21.67 ± 8.90 minutes, 95% CI: 2.03 to 9.71, P = .003) were shorter in the propofol group. Total anesthesia time remained shorter in the propofol group (35.53 ± 15.57 vs 43.74 ± 16.10 minutes, 95% CI: 0.02 to 16.39, P = .050). No significant differences were found in other outcomes, except more emergence agitation in the sevoflurane group ( P = .029). Ophthalmologist satisfaction was high and comparable. Respiratory adverse events were low and similar in both groups. Conclusions: Propofol with oxygen facemask resulted in shorter operating room discharge time and less emergence agitation compared to sevoflurane with LMA in pediatric ophthalmic EUAs. Both techniques yielded high ophthalmologist satisfaction and low respiratory event rates.