[Clinical comparison of propofol and remifentanil anaesthesia with sevoflurane and remifentanil anaesthesia for children with cleft lip and palate repair surgery].

OBJECTIVE: To compare the clinical effects and safety of propofol and remifentanil anaesthesia with sevoflurane and remifentanil anaesthesia for cleft lip and palate repair surgery in children. METHODS: Forty children undergoing elective cleft lip and palate repair surgery were randomly divided into two groups, 20 in each group. Group PR: Propofol and remifentanil anaesthesia; and group S: Sevoflurane and remifentanil anaesthesia. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SPO2), and end tidal carbon dioxide (ETCO2) were observed, and recorded at the time before the induction (T0), after 15 min of induction (T1), after 30 min of induction (T2), and after 1 min of extubation (T3). The time to extubation, incidence of restlessness, postoperative nausea and vomiting, and the complication of the airway were recorded. RESULTS: There were no significantly differences between the two groups with respect to sex, age, weight, category of operation, and the time of operation. In group PR, after the period of induction, two children used atropine for bradycardia. One was 3-years-old, and the other was 8-years-old. The HR of former was lower than 100 beats per minute, and the latter was lower than 70 beats per minute. The average of HR in group PR was increased after 1 min of extubation compared with that before induction (P<0.05). In group S, the average of HR was increased in 30 min after induction and 1 min after extubation (P<0.05), and HR kept in faster range compared with that in group PR (P<0.05) at the 15 min and 30 min after induction. During the operation, SPO2 and ETCO2 of both groups consistently maintained in normal range. The time to extubation was comparable in two groups. The incidence of agitation after surgery was significantly higher in group S (8 cases) than that in group PR (2 cases). There were no records of nausea, vomiting, asphyxia, and laryngospasm. CONCLUSION: Propofol and remifentanil anaesthesia was more significantly inhibited the HR of children. The emergence agitation has higher incidence in sevoflurane anaesthesia. Both methods can attain extubation requirement quickly.