Korean J Anesthesiol.  1998 Apr;34(4):739-744. 10.4097/kjae.1998.34.4.739.

A Comparision of Hemodynamic Changes of Total Intravenous Anesthesia (TIVA) and Isoflurane for Tonsillectomy in Children

• Kim SY
• Park BS
• Kim JH
• Kang HS

• KMID: 2039893
• DOI: http://doi.org/10.4097/kjae.1998.34.4.739

Abstract

BACKGROUND: In anesthesia for tonsillectomy in children, deep general anesthesia, rapid recovery to consciousness and the return of protective airway reflexes are desirable. This study was designed to estimate the efficacy of TIVA with propofol and fentanyl compared with isoflurane-N2O.
METHODS
Forty pediatric patients in ASA class I for tonsillectomy were allocated randomly to either TIVA with propofol and fentanyl (n=20, T) or isoflurane-N2O (n=20, I) group. Anesthesia was induced with propofol 1 mg/kg, fentanyl 3 microgram/kg IV and was maintained by continuous infusion of propofol 6~10 mg/kg/hr, fentanyl 6~10 microgram/kg/hr in T group and was induced with thiopental 5 mg/kg IV and maintained by inhalation of 1.2~2.5 vol% isoflurane in I group. The changes of hemodynamics, recovery time and complications were evaluated.
RESULTS
Systolic and diastolic pressure were increased in I group than T group at 1 min after intubation (p<0.05). Heart rate was increased in I group than T group at 1 min after intubation, 1 min and 5 min after incision, changing tube, end of operation and 5 min after end of operation (p<0.05). The recovery time was shorter in T group than I group (p<0.05). Pain on injection was more frequent in T group than I group (p<0.05), and excitatory effect during emergence was more frequent in I group than T group (p<0.05).
CONCLUSIONS
TIVA with fentanyl and propofol is better than isoflurane-N2O for anesthesia of tonsillectomy in children in view of small hemodynamic change, early and gentle recovery pattern and side effects.

Keyword

Anesthetic techniques: total intravenous anesthesia; Anesthetics, intravenous: fentanyl; propofol; Anesthetics, volatile: isoflurane

MeSH Terms

Anesthesia
Anesthesia, General
Anesthesia, Intravenous*
Blood Pressure
Child*
Consciousness
Fentanyl
Heart Rate
Hemodynamics*
Humans
Inhalation
Intubation
Isoflurane*
Propofol
Reflex
Thiopental
Tonsillectomy*
Fentanyl
Isoflurane
Propofol
Thiopental