Sevoflurane Provides Better Recovery as Compared With Isoflurane in Children Undergoing Spinal Surgery

Abstract

Rapid recovery is desirable in pediatric neurosurgical patients to obtain an early neurologic assessment. We compared the recovery characteristics of 2 commonly used anesthetic agents, sevoflurane and isoflurane, under bispectral index-guided anesthesia in children undergoing spinal surgery. Eighty children who underwent surgery for occult spinal dysraphism at the lumbar and sacral level were randomized to anesthesia with sevoflurane or isoflurane in oxygen and nitrous oxide. Anesthesia depth was guided by a bispectral index monitor kept between 40 and 60. In addition to time at emergence, extubation and discharge, recovery (modified Aldrete) score, and hemodynamics were compared. The 2 groups did not differ significantly with respect to demographics, duration of surgery and anesthesia, and intraoperative hemodynamic changes. Extubation (6.4±3.3 vs. 10.7±4.6) and emergence (7.8±3.4 vs. 12.8±5.6) times (minutes) were significantly shorter with sevoflurane (P<0.001). Time (minutes) to achieve full Aldrete (modified) scores was less with sevoflurane (13.9±5.3 vs. 20.3±6.5) than isoflurane (P<0.001). However, the time (minutes) to achieve discharge criteria from postanesthesia care unit (140.7±49.3 vs. 146±43.3) and first dose of postoperative analgesic (60±24.1 vs. 72±33.4) in addition to incidence of postoperative agitation were similar in both groups (P>0.05). Sevoflurane results in an earlier recovery and assessment of modified Aldrete score when compared with isoflurane.