The effects of sevoflurane-remifentanil and sevoflurane-fentanyl anesthesia in infants undergoing primary cleft lip surgery

Objective To compare the effectiveness and safety of sevoflurane-remifentanil and sevoflurane-fentanyl anesthesia for primary cleft lip repair surgery in infants.Methods Forty infants aged 3-9 months undergoing elective cleft lip repair surgery were randomly divided into one of the two groups with 20 cases each. Group R: sevoflurane and remifentanil anesthesia, Group F: sevoflurane and fentanyl anesthesia. HR,MAP and SpO2 were recorded at the time points of the induction (T0), during intubation (T1), 2 min after intubation (T2), at the beginning of operation (T3), 5 min (T4) and 30 min (T5), and at the time of extubation (T6). The following variables were recorded: the time of respiratory recovery, opening of eyes and extubation, the incidence of respiratory insufficiency after extubation, postoperative nausea and vomiting, restlessness, and the time to leaving the operation room.Results HR and MAP in both groups were significantly increased at T1, T3 and T6 (P0.05), and it was significantly faster in group F than group R (P0.05). Patients in the group F experienced shorter time of respiratory recovery, eyes opening, extubation and staying in the operation room (P0.01).The rate of respiratory insufficiency, nausea and vomiting in group R were lower than that in group F, while the rate of dysphoria was higher.Conclusion Combination of sevoflurane with remifentanil and fentanyl all produce effective anesthesia in infants undergoing cleft of lip repair. But sevoflurane-remifentanil provides more stable hemodynamics, fast recurrence and lower postoperative complications.