Clinical observation of sevoflurane and remifentanil used for anesthesia in children with cleft palate repair

PURPOSE: To evaluate the clinical benefit of sevoflurane and remifentanil for cleft palate repair in children. METHODS: Forty American Society of Anesthesiologiests physical status(ASA) Ⅰ or Ⅱ children aged 1-3 years undergoing elective cleft palate repair were randomly divided into two groups, 20 in each group. Group K: ketamine+propofol group, Group S: sevoflurane+remifentanil group. Before intubation, children in group K received ketamine(6-8mg/kg) by intramuscular injection and propofol(2mg/kg) by intravenous infusion, and then received propofol 4-10mg/(kg·h) during the maintenance of operation. In group S, anesthesia was induced by inhalation of sevoflurane and remifentanil 0.5μg/(kg·min) intravenously, was maintained with remifentanil 0.10-0.25μg/(kg·min) and sevoflurane at 1-1.5 minimum alveolar concentration(MAC). We adjusted the depth of anesthesia according to the change of hemodynamics. SPSS11.0 software package was used for comparison of the differences between the groups. RESULTS: All children finished the process of induction and intubation uneventfully. HR increased(P0.01) and MAP decreased(P0.05) significantly after induction in group K, and HR kept in faster range compared with that in group S(P0.05) during the intubation and separation of palatal flap. In group S, HR and MAP had a significant decrease after intubation (P0.01), but hemodynamics was stable throughout the operation. During the operation, SpO2 of both groups consistently maintained in normal range. In group S the time to awake and extubate was earlier than that in group K(P0.01), but the incidence of agitation was significantly higher. CONCLUSION: Sevoflurane and remifentanil can offer superior stable and comfortable operation in children.