A randomized multicenter study of remifentanil compared with halothane in neonates and infants undergoing pyloromyotomy. I. Emergence and recovery profiles

Peter J. Davis, Jeffrey Galinkin, Francis X. McGowan, Anne M. Lynn, Myron Yaster, Mary F. Rabb, Elliot J. Krane, C. Dean Kurth, Richard H. Blum, Lynne Maxwell, Rosemary Orr, Peter Szmuk, Daniel Hechtman, Suzanne Edwards, Lynn Graham Henson

Research output: Contribution to journalArticlepeer-review

82 Scopus citations

Abstract

Pyloric stenosis is sometimes associated with hemodynamic instability and postoperative apnea. In this multicenter study we examined the hemodynamic response and recovery profile of remifentanil and compared it with that of halothane in infants undergoing pyloromyotomy. After atropine, propofol, and succinylcholine administration and tracheal intubation, patients were randomized (2:1 ratio) to receive either remifentanil with nitrous oxide and oxygen or halothane with nitrous oxide and oxygen as the maintenance anesthetic. Pre- and postoperative pneumograms were done and evaluated by an observer blinded to the study. Intraoperative hemodynamic data and postanesthesia care unit (PACU) discharge times, PACU recovery scores, pain medications, and adverse events (vomiting, bradycardia, dysrhythmia, and hypoxemia) were recorded by the study's research nurse. There were no significant differences in patient age or weight between the two groups. There were no significant differences in hemodynamic values between the two groups at the various intraoperative stress points. The extubation times, PACU discharge times, pain medications, and adverse events were similar for both groups. No patient anesthetized with remifentanil who had a normal preoperative pneumogram had an abnormal postoperative pneumogram, whereas three patients with a normal preoperative pneumogram who were anesthetized with halothane had abnormal pneumograms after.

Original languageEnglish (US)
Pages (from-to)1380-1386
Number of pages7
JournalAnesthesia and analgesia
Volume93
Issue number6
DOIs
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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