Tehran University of Medical Sciences
Archives of Anesthesiology and Critical Care
2423-5849
8
3
2022
06
11
Anaesthetic Challenges in Children with Pierre-Robin Sequence: A Case Series
257
259
Haripriya
Ramachandran
Department of Paediatric Anaesthesia, Indira Gandhi Institute of Child Health, Rajiv Gandhi University of Health Sciences, Bengaluru, India.
Dammaningala
Bhagya
Department of Paediatric Anaesthesia, Indira Gandhi Institute of Child Health, Rajiv Gandhi University of Health Sciences, Bengaluru, India.
2021
09
19
2021
10
18
Pierre Robin sequence is associated with a triad of micrognathia, glossoptosis and airway obstruction. Securing the airway is of utmost importance in these patients. Use of vagolytic premedication, nebulisation with lignocaine to obtund airway reflexes, use of other airway devices (SGA) and equipment to assist in different airway scenarios helps in anaesthetising the patients.
https://aacc.tums.ac.ir/index.php/aacc/article/view/408
le="en_US">Background: It has been seen that volatile anaesthetics agents which are speedily eliminated with minimal breakdown should facilitate faster recovery from general anaesthesia. As compared to isoflurane-based anaesthesia, both sevoflurane and desflurane have shorter emergence times due to rapid induction and elimination.
Aim: The aim of this study is to compare and analyse the superiority of both agents, with regards to the emergence and recovery from anaesthesia, intraoperative hemodynamics, postoperative side effects and estimate the average quantity and cost-benefit of both volatile agents consumed.
Methods: Total of 100 cases above the age of 6 years undergoing tonsillectomy surgeries of ASA grade 1& 2 was included. Patients were allocated into two groups by computer-generated numbers. Group S: Anaesthesia maintained with 50/50 mixture of nitrous oxide/oxygen and sevoflurane. Group D: Anaesthesia maintained with 50/50 mixture of nitrous oxide/oxygen and desflurane. The parameters recorded were compared between the two groups using the unpaired t-test for continuous variables and P≤0.005 is deemed significant.
Results: There was no significant hemodynamic difference intraoperatively between sevoflurane and desflurane except in the desflurane group, heart rate was higher. Recovery was faster and better in Group D.
Conclusion: Postoperative recovery was better and faster and postoperative complication was lower in the desflurane group. Though the total cost of desflurane group was higher compared to sevoflurane but the use of desflurane can be justified with lesser complication, faster emergence from anaesthesia, faster shifting from PACU, lesser hospital stays, lower chance of nosocomial infection and lower cost of hospital stay.
https://aacc.tums.ac.ir/index.php/aacc/article/view/479