Related Experiment Video

Updated: Jul 16, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Quality differences in postoperative sleep between propofol-remifentanil and sevoflurane anesthesia in infants

Jacob Steinmetz1, Rolf Holm-Knudsen, Kirsten Eriksen

  • 1Department of Anesthesia, Centre of Head and Orthopedics 4231, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. jacobsteinmetz@dadlnet.dk

Anesthesia and Analgesia
|March 23, 2007
PubMed

Insights

Postoperative sleep disturbances are common in infants after anesthesia. Sevoflurane anesthesia resulted in longer continuous sleep durations compared to propofol-remifentanil anesthesia in infants undergoing cleft palate repair.

Area of Science:

  • Pediatric Anesthesiology
  • Pediatric Surgery
  • Sleep Medicine

Background:

  • Postoperative behavioral disorders are frequent in children, but their incidence in infants remains unclear.
  • This study investigates postoperative sleep disturbances in infants following anesthesia.
  • The hypothesis posits greater sleep disturbances with sevoflurane anesthesia compared to propofol-remifentanil anesthesia.

Purpose of the Study:

  • To compare the incidence and severity of postoperative sleep disturbances in infants.
  • To evaluate the impact of sevoflurane versus propofol-remifentanil anesthesia on infant sleep patterns post-surgery.
  • To assess the duration of sleep pattern recovery after surgical repair.

Main Methods:

  • 39 infants (4-6 months old) undergoing cleft lip-gum-palate repair were prospectively enrolled.
  • Participants were randomized to receive either sevoflurane and fentanyl or propofol and remifentanil anesthesia.
  • Parents maintained sleep diaries for two weeks pre- and post-surgery, recording awakenings, comfort difficulty, and longest continuous sleep duration.

Main Results:

  • Infants receiving sevoflurane anesthesia experienced significantly longer continuous sleep durations (median 7.2 hours) compared to those receiving propofol-remifentanil (median 5.1 hours).
  • No other significant differences in sleep parameters were observed between the anesthetic groups.
  • Sleep patterns were impaired post-surgery in both groups but returned to baseline within a median of 10 days for most infants.

Conclusions:

  • Postoperative sleep disturbances are evident in infants following both propofol-remifentanil and sevoflurane anesthesia.
  • Sevoflurane anesthesia appears to be associated with a lesser degree of sleep impairment in the initial weeks after cleft lip and palate repair in infants.
  • Infant sleep patterns generally recover within two weeks, irrespective of the anesthetic agent used.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...