Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Oct 1990
Comparative Study[Anesthesia using propofol during surgery of strabismus in children. A comparison of two different protocols of induction and maintenance].
The purpose of this study is an investigation of two protocols using propofol as induction and maintenance agent in 100 children scheduled for strabismus surgery (4-8 year, ASA I, NYHA I). Protocol I; Propofol 6 mg.kg-1 in 60 s with fentanyl 2 micrograms.kg-1 and vecuronium bromide 0.08 mg.kg-1 for induction, followed by propofol 11 mg.kg-1 for maintenance; Protocol II; Propofol 3 mg.kg-1 in 20 s with fentanyl 3 micrograms.kg-1 for induction, followed by propofol 12 mg.kg-1.h-1 for maintenance. It appears that the use of protocol I offers significant advantages compared with protocol II: a better quality of induction with a lesser incidence of pain during injection of propofol; a better quality of maintenance with very infrequent bradycardia from oculocardiac reflectivity; and a better recovery with a greatly reduced frequency of nausea and vomiting.
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The authors evaluated the return of sensory, motor, and sympathetic nervous system function following caudal block in children. Twenty children, ASA PS I, aged 5 +/- 4 yr (mean +/- SD), weighing 22 +/- 9 kg, scheduled for lower abdominal and urologic surgical procedures were studied. Anaesthesia was induced and maintained by halothane, N2O and oxygen. ⋯ Upper level of cutaneous analgesia was T10 +/- 2 after the block. Two hours after the caudal injection an incomplete motor blockade was found in 14 of 20 children, and at 4 hours no block was found in any child. Heart rate was significantly increased in the upright position (122 +/- 12 to 131 +/- 26 bpm at 2 hours, and 110 +/- 21 to 118 +/- 28 bpm at 4 hours), whereas arterial blood pressure was unchanged in the upright position.