Comparison between thiopentone and propofolas induction agents in premedicated children

ABSTRACT

In this study propofol 2.0-2.5 mg Kg[-1] was compared with thiopentone 4-5 mg kg[-1] in a randomised open study, as induction agents in pediatric anaesthesia. Fifty fit children between 3-16 years were to undergo elective surgery, were included in the study. Both propofol and thiopentone produced a rapid and smooth induction with a low incidence of side effects. All patients received i.m. premedication with papaveretum 0.4 mg Kg[-1] [maximum dose 15 mg] and hyoscine 0.008 mg Kg[-1] [maximum dose 0.3 mg]. After intravenous induction the anaesthesia was maintained with N[2-O].O[2] [6633] and 1.5% halothane either via mask or after tracheal intubation with succinyl choline 1 mg Kg[-1] We noticed that eight children [32%] after propofol complained of both pain and excitatory effect as opposed to four children [16%] after thiopentone. Apnea lasting longer than 30 seconds occurred only in 3 children 12% in each group despite the use of opioid premedication. Propofol caused greater decrease in arterial blood pressure [systolic diastolic and mean] than thiopentone which produce a significant increase in heart rate at 2 min. interval only. The overall auality of induction was assessed as being good, in all children receiving thiopentone compared with 18 [72%] of those receiving propofol. We noticed also that children anaesthetised with propofol awake significantly earlier after cessation of all anaesthesia. It is concluded that the use of propofol is safe in children and may have advantage where early recovery from anaesthesia is desirable, but offers no advantage over thiopentone, for routine induction of anaesthesia. So, propofol is a useful alternative to thiopentone as an induction agent in children