The ınvestigation of the effects of sevoflurane and sevoflurane-desflurane anesthesia on hemodynamics, emergence and early agitation in children strabismus surgery

The Investigation of the Effects of Sevoflurane and Sevoflurane-Desflurane Anesthesia on Hemodynamics, Emergence and Early Agitation in Children Strabismus SurgeryPurpose: In our study, we aimed to investigate the effects of sevoflurane anesthesia and desflurane anesthesia applied after sevoflurane induction on hemodynamics, emergence and early agitation in the children who had strabismus surgery.Material and Method: Totally 42 patients whose ages ranged between 2 and 10 and from the group of American Society of Anesthesiology (ASA) I-II who would have elective strabismus surgery were taken into the scope of this study after the consent of Çukurova University Faculty of Medicine Advisory Committee of Ethics and the written and oral consents of the parents had been taken. The patients were classified into two groups randomly.The anesthesia induction was provided with the mixture of 50% nitrous oxide, 50% oxygen and 6-8% concentration of sevoflurane by using the appropriate face mask. The maintenance of anesthesia was provided for sevoflurane concentration to be 1-2% in group 1 and for desflurane concentration to be 4-6% in group 2.The systolic and diastolic blood pressures, heart pulse rate and peripheral arterial oxygen saturation values of the cases were recorded. The records covered the minutes before induction, after the induction, after the intubation and the 15th, 30th, 45th and 60th minutes of the surgery. The operation time, the extubation, eye opening, obeying the warnings and orientation times and nausea-vomiting, laryngospasm and other adverse affects were recorded.Hemodynamic parameters, Modified Aldrete Emergence Score, Pediatric Anesthesia Delirium Scale and Watcha Behaviour Scale were recorded at 1st, 5th, 15th, 30th and 60th minutes in postoperative period.Findings: It was observed that systolic and diastolic blood pressures, heart pulse rate and SpO2 values were similar in two groups. It was also seen that extubation, eye opening, obeying the warnings, orientation spans were shorter in Group 2 than Group 1. No statistically significant difference was found in terms of Modified Aldrete Emergence Score, Pediatric Anesthesia Delirium Scale and Watcha Behavior Scale values. No cough, breath holding, laringospazm was occurred.Result: It was concluded that desflurane anesthesia applied after sevoflurane induction can be preferred to sevoflurane in maintenance of anesthesia for pediatric patients, since it provides shorter times of extubation, eye-opening, obeying the warnings and orientation, and gives similar results in terms of hemodynamic changes, emergence, postoperative agitation and nausea-vomiting.Key Words: Sevoflurane, desflurane, hemodynamic parameters, emergence, early agitation.