Hemodynamic Differences between Propofol-Remifentanil and Isoflurane-Remifentanil Anesthesia for Repair of Cleft Palate in Children

Background: Cleft palate repair is associated with hemorrhage and hemodynamic changes in children. This study aimed to compare hemodynamic changes during cleft palate repair in patients anesthetized with isoflurane-remifentanil and propofol-remifentanil. Methods: In this randomized, double blind study, 100 cleft palate repair candidates who aged under three years were allocated to two groups of 50 to receive either isoflurane-remifentanil or propofol-remifentanil for maintaining anesthesia. Results: The mean systolic and diastolic blood pressure and the mean arterial pressure were significantly lower in the propofol-remifentanil group (P < 0.001). The mean extubation time (P < 0.001), time to first analgesic administration (P = 0.04), and recovery time (P < 0.001) were significantly longer in the isoflurane-remifentanil group. Conclusion: Propofol-remifentanil-based anesthesia caused more stable hemodynamic state in patients undergoing cleft palate repair. The mean systolic and diastolic blood pressure, as well as the mean arterial pressure, were lower with propofol-remifentanil administration. Therefore, this combination can lower the risk of intraoperative hemorrhage.