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Time to extubation in infants undergoing pyloromyotomy -- isoflurane inhalation vs remifentanil infusion

Sonia Ben Khalifa1, Sami Blidi, Mehdi Trifa

  • 1Department of Anesthesia and Intensive Care, Children's Hospital, Tunis.

Middle East Journal of Anaesthesiology
|July 9, 2009
PubMed

Insights

Remifentanil infusion provided superior intraoperative analgesia compared to isoflurane inhalation in infants undergoing pyloromyotomy. This improved pain management did not prolong anesthesia recovery time, making it a potentially better choice for pediatric surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Pain Management

Background:

  • Infantile hypertrophic pyloric stenosis (IHPS) can cause metabolic alkalosis, potentially delaying anesthesia recovery, especially with opioid use.
  • Optimizing anesthesia and analgesia is crucial for safe and effective pediatric surgical procedures.

Purpose of the Study:

  • To compare the efficacy of isoflurane inhalation versus remifentanil infusion for anesthesia maintenance.
  • To evaluate the impact of these anesthetic techniques on extubation time and perioperative analgesia quality in infants undergoing pyloromyotomy.

Main Methods:

  • A prospective study involving 30 full-term infants undergoing pyloromyotomy.
  • Randomized allocation to either isoflurane inhalation or remifentanil infusion for anesthesia maintenance.
  • Standardized anesthetic induction and intraoperative monitoring, with paracetamol administration at skin closure.

Main Results:

  • No significant difference in the time to extubation between the isoflurane and remifentanil groups.
  • Infants receiving remifentanil infusion exhibited significantly lower intraoperative heart rates.

Conclusions:

  • Remifentanil infusion offers superior intraoperative analgesia compared to isoflurane in infants undergoing pyloromyotomy.
  • The use of remifentanil does not adversely affect the time to extubation, suggesting a favorable risk-benefit profile for this analgesic approach.
Abstract

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