Key result
Isoflurane minimizes arrhythmias versus halothane and airway problems versus enflurane during pediatric adenoidectomy.
Why the study?
Comparisons of airway problems, heart rates, cardiac arrhythmias, ventilation, and stress hormone reactions during halothane, enflurane, and isoflurane anaesthesia with different premedications in children undergoing adenoidectomy were studied to evaluate their effects.
Do different volatile anesthetics and premedications affect airway problems, arrhythmias, and stress responses in children undergoing adenoidectomy?
RCT (n=48)
Do different volatile anesthetics and premedications affect airway problems, arrhythmias, and stress responses in children undergoing adenoidectomy?
In children undergoing adenoidectomy, enflurane and isoflurane are associated with fewer cardiac arrhythmias than halothane, and a premedication of diazepam, morphine, and scopolamine effectively blunts stress hormone responses to surgery.
Should not yet change practice in pediatric adenoidectomy; leaves open optimal volatile agent selection for airway-arrhythmia balance.
In 48 children subjected to adenoidectomy, comparisons of airway problems, heart rates, cardiac arrhythmias, ventilation and stress hormone reactions were studied during halothane, enflurane and isoflurane anaesthesia. Sixteen children were anaesthetized with either of the three agents and eight patients in each group received diazepam 0.25 mg kg-1 and atropine 0.015 mg kg-1 rectally (DA) as premedication and the remainder diazepam 0.5 mg kg-1, morphine 0.15 mg kg-1 and scopolamine 0.01 mg kg-1 (DMS) rectally. All children were intubated and breathing spontaneously. Equianaesthetic inspired concentrations of halothane, enflurane and isoflurane were used. Airway problems were of the same magnitude during halothane and isoflurane anaesthesia but were less frequent with both agents compared with enflurane anaesthesia. DMS reduced the number of airway reactions in all groups. Respiratory rates were uninfluenced by anaesthesia, intubation and surgery during enflurane anaesthesia. Cardiac arrhythmias were less frequent with enflurane and isoflurane than with halothane. Plasma ACTH and cortisol were similar with all three agents. During induction of anaesthesia in the DA-premedicated halothane group, however, plasma catecholamines were higher than in the group which received DMS, in contrast to the findings during enflurane and isoflurane anaesthesia. The DMS premedication decreased the response of plasma ACTH, cortisol and plasma catecholamines to surgery.
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Johannesson et al. (1987) conducted an RCT in Adenoidectomy (n=48). Halothane, enflurane, and isoflurane vs. Compared against each other was evaluated on Airway problems, heart rates, cardiac arrhythmias, ventilation and stress hormone reactions. In children undergoing adenoidectomy, halothane and isoflurane resulted in fewer airway problems than enflurane, while enflurane and isoflurane caused fewer cardiac arrhythmias than halothane.
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