Abstract SNACC-96

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Comparison between sevoflurane and desflurane on emergence and recovery characteristics of children undergoing surgery for spinal dysraphism

Rath G, Gupta P, Prabhakar H, Bithal P
All India Institute of Medical Sciences, New Delhi, , India

Background: Rapid recovery is desirable after neurosurgery as it enables early postoperative neurological evaluation and prompt management of complications. Till date, none of the study compared the recovery characteristics in pediatric neurosurgical patients. Hence, we carried out this study to compare the effect of sevoflurane and desflurane anesthesia on emergence and extubation in children undergoing spinal surgery.
Methods: Sixty children, aged 1-12yrs, undergoing elective surgery for lumbo-sacral spinal dysraphism were enrolled. Anesthesia was induced with sevoflurane using face mask. Then, the children were randomized to receive the maintenance of anesthesia with either sevoflurane or desflurane along in a mixture of O2 and N2O, fentanyl (1µg/kg/hr), and rocuronium. The anesthetic depth was guided by bispectral index (BIS) monitoring with a target BIS between 45 and 55. Perioperative data with regard to demographic profile, hemodynamics, emergence and extubation times, modified Aldrete score, pain (Objective Pain Score), agitation (Cole’s Agitation Score), time to first analgesic, and complications, thereof, were recorded. Statistical analysis was done using STATA 11.2 and data are presented as median (range) or mean±SD.
Results: The demographic profile, hemodynamics, modified Aldrete score, pain and agitation scores, and time to first analgesic were comparable in between the two groups (p>0.05). The emergence time was shorter in desflurane group [2.75(0.85-12) min] as compared to sevoflurane [8(2.5-14) min] (p< 0.0001). The extubation time was also shorter in desflurane group [3(0.8-10) min] as compared to the sevoflurane group [5.5(1.2-14) min] (p=0.0003).
Conclusions: Desflurane provided earlier tracheal extubation and emergence as compared to sevoflurane in children undergoing surgery for lumbo-sacral spinal dysraphism.


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