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Sevoflurane versus halothane: postoperative maladaptive behavioral changes: a randomized, controlled trial

Zeev N Kain1, Alison A Caldwell-Andrews, Megan E Weinberg

  • 1Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. zeev.kain@yale.edu

Anesthesiology
|March 26, 2005
PubMed

Insights

Sevoflurane anesthesia in children does not increase postoperative behavioral issues compared to halothane. This study found no significant differences in maladaptive behaviors or sleep disturbances, offering reassurance for pediatric anesthesia choices.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Psychology

Background:

  • Postoperative behavioral changes in children are a concern following anesthesia.
  • Sevoflurane and halothane are commonly used anesthetic agents in pediatric surgery.

Purpose of the Study:

  • To compare the incidence of postoperative maladaptive behavioral changes in children receiving sevoflurane versus halothane anesthesia.
  • To assess the impact of anesthetic choice on emergence status, pain, anxiety, and sleep disturbances.

Main Methods:

  • A double-blind, randomized controlled trial involving 102 children and their parents.
  • Random assignment to either halothane or sevoflurane anesthesia groups with controlled intraoperative protocols.
  • Postoperative assessment of behavioral changes, anxiety, pain, analgesic consumption, and sleep using validated measures and actigraphy.

Main Results:

  • No significant differences were observed between the sevoflurane and halothane groups in terms of preoperative anxiety, postoperative pain, or analgesic requirements.
  • The incidence of emergence delirium was not significantly different between the two anesthetic groups.
  • No statistically significant group differences were found in the occurrence of postoperative maladaptive behaviors or sleep disturbances (percent sleep, night awakenings).

Conclusions:

  • Sevoflurane anesthesia in children is not associated with a higher incidence of emergence delirium compared to halothane.
  • The study found no increased risk of maladaptive postoperative behavioral changes or sleep disturbances with sevoflurane use.
  • These findings suggest sevoflurane is a safe alternative to halothane regarding postoperative behavioral and sleep outcomes in pediatric patients.
Abstract

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