Anestesia intravenosa versus anestesia inhalatoriavómitos postoperatorios en niños.

Abstract

INTRODUCTION. No anaesthetic technique has been demonstrated to be a risk or a protection factor of postoperative vomiting (POV) in children. If an anaesthetic delays the rythm of gastric emptying, moreover when there are associated factors, it will be more risk of postoperative aspiration , of VPO, delay in restitution of oral feeding and decrease in efficacy of oral farmacs. The objectives were to study the effect of intravenous and inhalation anaesthesia on gastric fluid, and to study the incidence of POV with both anaesthetic techniques in children. MATERIALS Y METHODS. 114 children ASA I and II between 1 and 12 years scheduled for elective surgery less than 2 hours were randomized in two groups depending on the anaesthetic technique administered: propofol, oxygen and air (Group 1: n=59) and sevoflurane, oxygen and air (Group 2: n=55). Hemodinamic parameters were measured, residual gastric volume (VGR) and gastric pH were measured with the method of blind aspiration at the end of anaesthesia, and incidences of POV the first 24 hours were also measured with both techniques. RESULTS. The median arterial pressure after intubation was lower in Group 2. There were no differences in RGV between Group 1 (0,21±0,11 ml/kg) and Group 2 (0,22±0,11 ml/kg), nor in gastric pH between Group 1 (3,47±1,67) and Group 2 (3,01±1,46) at the end of anaesthesia. The incidence of POV was similar in both groups (10% in Group 1 and 9% in Group 2). CONCLUSIONS. The anaesthetic technique with sevoflurane, oxygen and air could be an alternative technique to intravenous anaesthesia to try to decrease the incidence of POV in children, because it has not demonstrated to produce more incidence of POV and it produces similar RGV and gastric pH at the end of anaesthesia in children ASA I and II scheduled for elective surgery less than 2 hours.