• J Aono, W Ueda, K Mamiya, E Takimoto, and M Manabe.
• Department of Anesthesiology, Kochi Medical School, Japan.
• Anesthesiology. 1997 Dec 1;87(6):1298-300.

BackgroundIn the authors' clinical experience, preschool children are more likely to show delirium after sevoflurane than are older children.MethodsSixty-three preschool boys aged 3-5 yr (classified as American Society of Anesthesiologists [ASA] physical status I), and 53 school-age boys aged 6-10 yr (ASA physical status I) who underwent minor urologic surgery were randomly assigned to receive either halothane or sevoflurane, thus creating four groups: preschool-halothane (n = 32), preschool-sevoflurane (n = 31), school-halothane (n = 27), and school-sevoflurane (n = 26). Anesthesia was induced by inhalation of halothane or sevoflurane in oxygen and was maintained at 1 minimum alveolar concentration of each agent throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5-1.0 ml/kg 0.25% plain bupivacaine and topical infiltration with 3-5 ml 1% lidocaine were provided for all patients. Recovery characteristics and incidence of delirium on emergence were compared among the four groups.ResultsTwo patients in the preschool-halothane group, one in the preschool-sevoflurane group, and one in the school-halothane group were excluded from the comparison because of insufficient analgesia or agitation before induction. In both age groups, the time to emergence from sevoflurane was significantly faster (about 3 min) than from halothane. The incidence of delirium during recovery in the preschool-sevoflurane group (40%) was significantly greater than that in the other groups (preschool-halothane, 10%; school-halothane, 15.4%; school-sevoflurane, 11.5%).ConclusionSevoflurane provided quicker emergence and early recovery compared with halothane, but the incidence of delirium was greater in preschool boys after sevoflurane.

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